Home Health Additional Document Requests (ADR) - Virtual

GENERAL SESSION OVERVIEW

The workshop will begin with a breakout session by National Government Services (NGS) and follow with a general overview of Additional Document Requests (ADRs) by expert faculty Annette Lee, who worked for over a decade with a MAC in medical review and education. This session will review the different types of audits and the processes followed by Medical Review, CERT, SMRCs and RACs. Attendees will gain a better understanding of the medical review process, Medicare’s Additional Development Request, and documentation processes. Additionally, after the NGS breakout session, Ms. Lee will discuss the appeals process and provide examples of documentation that would support the medical necessity for both home health and hospice.  The breakout sessions will provide the additional details!

BREAKOUT SESSION OVERVIEW 

National Government Services (NGS) Trends in Home Health: New News is Good News!

This educational session has been designed to provide a thorough review of Medicare compliance information with a focus on updates and changes to home health federal Medicare regulations, current medical review audits and how to avoid Medicare claims denials for home health. Attendees will be offered up-to-date references and resources, as well as NGS contact information for future questions regarding Medicare regulations.

Objectives:

•          Provide a detailed understanding of relevant changes to the federal Medicare home health regulations.

•          Offer home health providers information regarding the current auditing of claims, claim denials, and explore ways to avoid documentation errors.

•          Deliver current references and resources to assist the provider in their day-to-day Medicare workload.

FACULTY

Annette Lee, RN, MS, HCS-D, COS-C

CEO
Provider Insights, Inc.

Annette is a registered nurse, with a Master’s in Health Care Administration, practicing since 1990, with the majority of her nursing experience in home health. For over a decade she worked with the CMS Medicare Administrative Contractor (MAC) where she provided review of, and education on home health and hospice documentation. Annette then began providing outreach and provider education regarding Medicare reimbursement issues and effective documentation strategies, assisting providers with ADRs and appeals. Today she marries together her experience in the “real world” and the inside knowledge of Medicare to ensure providers can meet the requirements of CMS, and ensure compliant, efficient operations. She presents nationally on the Conditions of Participation, (COPs), OASIS, PDGM, HIS, LCDs, and documentation and coverage for both the home health and hospice benefits. Annette holds both the Certificate for OASIS Specialist-Clinical and the Home Care Coding Specialist-Diagnosis certification.

Erin Musumeci, RN, Clinical Consultant

National Government Services    

Erin is the clinical educator at National Government Services, focusing on home health and hospice education.  She is a dedicated and skilled RN with a broad range of healthcare experience including acute, post-acute, home health and hospice. Erin spent more than a decade in nursing and has experience as a Quality Improvement Analyst in the acute care setting. Erin worked in both the home health and hospice environments as a case manager in homes, facilities, and infusion suites and has professional experience as a Transitional Care Coordinator. 

CANCELLATIONS

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.

CONTINUING EDUCATION UNITS (CEUs)

Provider approved by the California Board of Registered Nursing (Provider #CEP17394) for five (5) contact hours of continuing education. Continuing Education report will be issued to attendees once attendance has been confirmed.