Pre-Claim Review: The First Three Months | Provider and Intermediary Experiences is proudly presented to you by National Association for Home Care & Hospice. Thank you. We hope that you enjoy your course.
Participants will learn from this case study and take part in an analysis of this Illinois agency’s experience with the pre-claim review demonstration project. Successful navigation of the pre-claim review process involves working well with fiscal intermediaries on data exchanges, and having a solid understanding of Medicare’s requirements. How this change impacts agencies – in workload, interchange of information, and through financial implications – is important to know from the get-go. This case study will help you identify some best practices and solutions that keep the pre-claim review process as streamlined as possible.
Categories: Clinical, Legal, Regulatory, Compliance, Operations
Key Words: Medicare, Documentation
Audiences: Home Health, Hospice, Physicians, Nurses, Therapists
Objective 1: Detail the requirements of the pre-claim review demonstration and the workload associated with it
Objective 2: Detail the process of tracking pre-claim review documents and approval or disapproval, and actions of corrections
Objective 3: Describe what educational resources have been completed and what education is planned to help home health agencies, certifying physicians, practitioners, and beneficiaries
Instructors:
Sharon Kim Gaffey, MSN, RN
CEO & Founder, Gaffey Home Nursing & Hospice; Sterling, Illinois
Tammy Tucci, BA
Manager of Provider Outreach & Education, Palmetto GBA; Columbia, South Carolina