2020 PDGM (Patient Driven Grouping Model) \ PPS Refinement

Medicare has proposed a new payment system for 2020 Patient Driven Grouping Model (PDGM). The 153 HHRG scores will be expanded to 216. This is the most dramatic payment change since 2000!

This seminar will show you the change for Patient Driven Grouping Model (PDGM) Payment System

  1. Navigate the Patient Driven Grouping Model (PDGM) effective January 1, 2020
  2. Elimination of therapy visit payments
  3. 60 day to 30 day episodes billing
  4. Elimination of medical supplies reimbursement
  5. 2.1% payment update for 2019
  6. Home Infusion therapy services transitional payment
  7. Outlier changes

Meet the Speaker

James Plonsey - President Medicare Training & Consulting Inc.

James Plonsey

President, Medicare Training & Consulting, Inc.

James E. Plonsey, President of Medicare Training & Consulting, has been involved in healthcare accounting and finance since 1980. He has been a member of the Healthcare Financial Management Association since 1983. Jim is well versed in all aspects of Medicare and Medicaid participation and reimbursement. His background includes experience with providers, with the Blue Cross Association, with a major teaching hospital, and with a major accounting firm; prior to starting his own firm, Medicare Training & Consulting, in 1990. Jim also organizes and conducts seminars on a variety of issues concerning reimbursement.

James Plonsey has over 30 years of healthcare experience including six years with Blue Cross Blue Shield Association, training 750 Medicare auditors for the Fiscal Intermediary. He has owned a Home Health, West Valley Home Health in Utah.

2020 – Patient Driven Group Model (PDGM)
  • Most dramatic payment change since 2000!
  • Navigate the Patient Driven Grouping Model (PDGM) effective 01/01/2020
  • Eliminated extra reimbursement for Therapy Visits
  • Move from 60 day payment system to 30 day payment schedule
  • Changes to Non-Routine Medical Supplies
  • Additional Reimbursement for Hospital or SNF Admissions
Topics2019 Survival Guide2 Day PDGM
Navigate the Patient Driven Grouping Model (PDGM) effective January 1, 2020
X X
60 day to 30 day episodes billing
X X
Home Infusion therapy services transitional payment
X X
Outlier changes
X X
Eliminated extra reimbursement for Therapy Visits
X X
Move from 60 day payment system to 30 day payment schedule
X X
Changes to Non-Routine Medical Supplies
X X
Outpatient therapy reimbursement
X X
New cost report forms updatesX X
RAP Reduction Strategies X X
Dealing With Cash Flow Reduction
X X
Elimination Of Medical Supplies Reimbursement
X
Medicare Advantage Strategies
X
Md Physician Billing Rules Affecting HHA Referral
X
CLIA Billing Rules
X
Marketing Strategies Under PDGM
X
Flu Shots Reimbursement
X
Identify 5 Sure-Fire Strategies To Deal To Win Under PDGM
X X

Seminar Topics

  • Outlier per unit changes
  • HHA free patient rides rules
  • Negative wound pressure therapy billing
  • Medicare Advantage strategies
  • MD Physician billing rules affecting HHA referral
  • Outpatient therapy reimbursement
  • CLIA billing rules
  • New cost report forms updates

Who Should Attend

  • Home Health Agency Administrators
  • Nurse Administrators
  • Controllers
  • Billers
  • Directors of Nursing

Pricing

1 Person Total

$529

2 day training
Single agency
Course Materials
Lunch
Coffee

2 Persons Total

$998

2 day training
Same agency
Course Materials
Lunch
Coffee

14 Continuing Education Units (CEU)

CANCELLATION POLICY:    If Medicare Training and Consulting must cancel a seminar due to low registration, registrants will receive a full refund by their method of payment.  If a participant cancels a reservation, notification must occur 15 or more calendar days before the meeting date for a 100% refund.  A participant may enroll in a future course in lieu of a cash refund.  Medicare Training & Consulting is unable to grant refunds for lodging, airfare, and other expenses.

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