Billing is a very critical part of home health. This workshop will lay a concrete foundation for new billers, as well as, experienced billers by giving billers a more effective approach to the Medicare PPS regulation, conducting Medicare verifications and understanding adjustments. We will discuss Medicare verifications on patients with HIQH screen examples & review adjacent episode calculations - field by field on claim forms. We will review the process of auditing a pre-bill for final claim purposes, both Medicare and Non-Medicare Payors, and review the details of billing for Non-Routine Supplies using list and billing guidelines. Direct Data Entry Screens will also be reviewed.
At the conclusion of the seminar, participants will be able to:
1. Calculate and evaluate the HHRG, HIPPS Code and Episode Exceptions.
2. Effectively verify Medicare Eligibility of patients and complete a RAP and Final Claim form. Calculate Adjacent Episodes.
3. Describe the process for effectively auditing a Chart for purposes of identifying prebill issues and Medicare Secondary Payor Issues.
4. Identify reason codes on electronic Medicare RAs. Analyze tough Billing Scenarios including effects on OASIS-C data. |
