The workshop will discuss the workings of the medical review process, Local Coverage Determinations (LCDs), RAC, claim denials, ADR’s, and the appeal process. It will also help attendees gain a better understanding of the RHHI’s role and how to effectively collaborate and work with the RHHI. Additionally, the program will reveal top medical Review denials, why NGS are seeing those denials, and documentation tips on avoiding those denials. Attendees will also learn what NGS is looking at in the data to start a medical review audit.

 Top 10 Objectives:

1. Review and explain data from intermediaries medical review
2. Review and explain Medicare’s Additional Development Request, and Progressive Corrective Action processes
3. Review the components of the Hospice LCD and explain ways to use the LCD for compliance and documentation.
4. Review and explain CMS guidelines for hospice services and the levels of care. Discuss documentation that would     support these needs.
5. Review and explain Recovery Audit Contractors (RACs)
6. Review and explain Comprehensive Error Rate Testing (CERT)
7. Discuss National Government Services’ Medical Review top denials and ways to avoid those denials
8. Discuss Coverage and Documentation
9. Discuss Local Coverage Determination
10. Discuss and review real-life Scenarios pertinent to the material presented

Who Should Attend?

This workshop is recommended for all Hospice administrators, managers, and clinicians. It is also recommended for quality assurance personnel.

9:00am - 3:30pm (Networking lunch provided)
Registration begins at 8:00am

Annette Lee, RN, MS, COS-C
Ms. Lee has been an RN for 20 years, with 12 years of experience in home health management and patient care service delivery. Over the last 10 years she has provided review and education at the Regional Home Health and Hospice Intermediary (RHHI) level for home health and hospice providers. Annette has a wide array of experience that makes her accessible and a valuable resource to providers. An RN since 1990, she continued her education to obtain her
Master’s in Health Care Administration. Her career has had an emphasis in community health care, with positions ranging from a community case manager to The Provider Outreach and Education Coordinator at Cahaba GBA. These experiences have made Annette an expert in both the clinical and quality medical review sides of coverage for home health and hospice. She also teaches on an array of governmental forms and requirements such as the OASIS, HHABN and the Hospice and Home Health LCDs and documentation. Annette is the founder of Provider Insights, Inc.

Corrinne R. Ball, RN, CPC
Corrinne is a graduate of Southern State Community College (1986) as a Licensed Practical Nurse and 2001 with an Associates Degree in Nursing. Her clinical experience has focused on Neurology, Pulmonology, Pediatrics, Telemetry and Critical care. Most of her clinical experience was obtained at Scripps Clinic in San Diego, California. She has worked for National Government Services for six years. Two years as a Medical Review Analyst and 4 years in Provider Outreach and Clinical Education Consultant. She was certified in 2009 as a Certified Professional Coder.

CANCELLATIONS:
Received 10 business days prior to the program date are subject to a 20% handling fee. Cancellations must be in writing. NO REFUNDS will be issued for cancellations received within 10 business days of the program. Refunds will NOT be made for no-shows. However, substitutions will be allowed. Should CAHSAH cancel the program, a full registration fee refund will be issued.

*If you are having problems with the online registration,
please download the registration form, fill it out, and fax to (916) 641-5881
To place a registration by phone with credit card information, please contact (916) 641-5795 ext 113.