Medicare Home Health Reimbursement Workshop


Home Health billers and collectors are extremely important to agencies thriving in the current challenging environment! Directors, Managers and Supervisors must also know the Medicare HH billing requirements as key players in the agency's financial success and survival. Be the first to be current on all Medicare billing regulations for 2019 & proposed for 2020. If you are part of the revenue cycle in your agency this workshop is a must.

Melinda Gaboury will lay a strong foundation for your home health staff by providing a more effective approach to the Medicare PPS regulation requirements. She will discuss Medicare patient verification, adjacent episode calculations, details - field by field on claim forms and billing updates. Melinda will present on how to effectively audit a pre-bill for final claim purposes, both Medicare and Non-Medicare Payers, and review the details of billing for Non-Routine Supplies using billing guidelines.

As we all know, more and more scrutiny of agency records has been taking place in the form or ADR and RAC reviews. This session will outline the current risks and outline steps to manage that risk and include how to utilize PEPPER report data as a risk management tool.

CMS has finalized implementation of the Patient Driven Groupings Model (PDGM) in 2020, This workshop will include a session for updating the status of PDGM and what we can expect.

  • Review Key PPS Billing Highlights for 2019
  • Calculate and evaluate the HHRG, HIPPS Code and Episode Exceptions
  • Verify Medicare Eligibility of patients and calculate Adjacent Episodes. Complete a RAP and Final Claim.
  • Describe the process for effectively auditing a Chart for purposes of identifying pre-bill issues and Medicare Secondary Payor Issues.
  • Describe how to effectively use data such as the Pepper Reports to mitigate financial risk
  • Review PDGM and what to is to come.



Melinda Gaboury, COS-C

Healthcare Provider Solutions, Inc.

Melinda A. Gaboury, with more than 27 years in home care, has over 17 years of executive speaking and educating experience, including extensive day to day interaction with home care and hospice professionals.  She routinely conducts Home Care and Hospice Reimbursement Workshops and speaks at state association meetings throughout the country.  Melinda has profound experience in Medicare PPS training, billing, collections, case-mix calculations, chart reviews and due diligence.  ZPIC, RA, ADR & TPE appeals with all Medicare MACs have become the forefront of Melinda’s current impact on the industry.  She is currently serving on the NAHC/HHFMA Advisory Board as ex-officio and is Associate Director on the Home Care Association of Florida Board of Directors.  Melinda is also the author of the Home Health Guide to OASIS-D: A Reference for Field Staff.


Cancellations are subject to 20% handling fee. There will be NO REFUNDS issued for cancellations received within 10 business days prior to program. Cancellations must be in writing. 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.


Provider approved by the California Board of Registered Nursing (Provider #CEP2463) for six and one half (6.5) contact hours of continuing education. You must be present for the entire workshop to earn Continuing Education Units. No partial credits can be given. Certificates are distributed at the close of the program.