The Patient-Driven Grouping Model (PDGM) represents the most sweeping changes in the home health industry since the introduction of the Prospective Payment System (PPS) in 2000.

Being ahead of the crowd and understanding the role YOUR documentation plays such an important role. Solid Home Care documentation is the KEY to survival with Targeted Probe and Educate (TPE) audits, accurate functional scoring, star ratings, and ultimate PDGM success. Learn the importance of the comprehensive assessment to support the POC and OASIS responses and be prepared for the survey by adherence to the CoP’s.

This seminar offers education and strategy to provide agency owners, administrators, business managers and billing staffs with practical information to equip your agency to collect and retain reimbursements due from all payer sources. The continuing shift in the industry to tie payments to quality services hits home in 2023 with the nationwide implementation of Home Health Value Based Purchasing. National Medicare enrollment continues to move toward enrollees choosing Medicare Advantage Commercial Insurers while the Medicare Fee- For Service enrollment continues to diminish as a percentage of total. Our experienced industry experts will provide valuable practical insight that will be beneficial and enlightening to newly certified or long-standing home health provider administration and staff members.

PDGM Survival Guide

The seminar will cover the 2024 HHA Final Rule published in November 2023 for billing periods ending January 1, 2024. CMS has announced a 0.4% Base rate increase and a 0.4% outlier increase. Medicare adjusted all 432 PDGM case-mix rates, impacting your medicare reimbursement in 2024.

Medicare Advantage Plans.

More than half of all Medicare beneficiaries are covered by an Advantage Plan. The seminar will show all HHAs how to get properly reimbursed and get patients back on traditional Medicare. The class will also identify a surefire way to get more reimbursement from Advantage Plans for Therapy Visits.

Flu Shot Billing

HHA may provide Flu Shots to Medicare and non-medicare patients. The agency must bill the MAC on a UB-04 and will receive 100% reimbursement from Medicare.

Outpatient Therapy 80 Part B Billing

HHA may provide Outpatient Therapy without obtaining a new license or certification. You will learn the reimbursement rules and even be reimbursed for telehealth visits.

Earned Retention Tax Credit (ERTC)

Providers can receive this credit for 2020 and 2021 payroll tax credits. Even though the IRS has put a pause on processing the claims, it is still accepting applications. Tax Professionals have told many providers they were ineligible for this credit but eligible under an alternative Government Shutdown mandate.