Certifications & Elections: Examining the Requirements & Avoiding the Perils

Event Information
Product Format
Prerecorded Event
Conference Date
Thu, Aug 10, 2017
60 minutes
Product Description

Election of Benefits and Certification of Terminal Illness: Requirements and Risk Areas

Would you like to receive payments for the services provided to Medicare beneficiaries? To receive payments for these services, you must ensure compliance with two technical requirements of the hospice Medicare benefit: the election of benefits (EOB) and the certification of terminal illness (CTI).

Join this session, where expert speaker Susan Balfour, BA, RN, will provide you with a comprehensive review of the requirements, specific risk areas and the common stumbles for each requirement. Susan will also review the findings in the OIG report, “Hospices Should Improve Their Election Statements and Certifications of Terminal Illness.” You will learn how to access the actual regulations and to identify the risk areas. In addition, you will learn to feel confident in your understanding of the hospice Medicare regulations governing certifications and election, and learn how to evaluate your agency processes and avoid the common pitfalls.

Session Highlights

  • Where the technical provisions are found in the hospice Medicare regulations
  • Time frames for the initial certification and for recertifications
  • Verbal and written certifications: how the pieces or parts fit together
  • The brief narrative: content and completion
  • Election of benefits: the required elements
  • Beneficiary choice: selection and identification of the attending physician
  • Common stumbling blocks in both processes
  • What the OIG has to say about it all

 Session Agenda

  • 42 CFR 418 hospice program (The federal regulations)
  • The election of benefit (EOB) form
  • The OIG’s concerns about EOB information
  • The certification of terminal illness process
  • The OIG’s concerns about CTIs
  • Election of benefits
  • Informed consent: Generic vs. hospice EOB
  • Timely filing of the notice of election (NOE)
  • Certification of terminal illness
  • Hospice Medicare regulations
  • Initial certification of terminal illness (CTI)
  • CTI: Timeframes for recertification
  • The clinical/billing connection

Who Should Attend

  • Clinical management
  • Compliance
  • IDG members
  • Education
  • QAPI

Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.

Order Below or Call 1-844-384-4744 Today

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About Our Speaker

Susan Balfour - Hospice and Medicare Billing Coding Expert

Susan Balfour, BA, RN has a hospice career spanning 25 years that includes tenure as an executive director of a community-based hospice agency and Director of Regulatory and Clinical Affairs with the Carolinas Center for Hospice and End of Life Care. A regular presenter on a variety of topics, she is committed to helping hospices develop deep regulatory competence and avoid the unnecessary costs of over-compliance.

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