June 11 | Homebound Status and Need for Skilled Care
To qualify for home health services under Medicare, a patient needs to be considered homebound. How do you show this in your documentation? How do you get all your staff AND the physicians to understand what homebound is and what it is not? Does a patient have to be in their home constantly to be considered homebound? We’ll answer these and other riveting homebound questions and deep dive into documentation to ensure your patient’s homebound status is conveyed to medical reviewers. This topic is a struggle for physicians, and they don’t want to deal with it. We’ll talk about ways to make homebound status easily shown in all documentation.
You take great care of your patient but still get denied on your documentation! You know you’re providing the services needed, but struggle to get your documentation to reflect it. How do you make sure you’re giving yourself credit for EVERYTHING you do? Let’s work together and figure out how to show your education and experience in your care. Bring along some scenarios you’re struggling with and you’ll leave with answers and confidence!
June 18 | Face-to-Face and Certification
Face-to-face encounters continue to be the most problematic and most frequent cause for denial. Let’s dive into all the details of face-to-face encounters for home health. What do we need to do to make sure ALL the regulations are met, along with hints and ideas on how to work together with our physician community for mutual documentation success? We’ll provide a check list to use for face-to-face encounters to make sure nothing is forgotten or misinterpreted. Let’s make face-to-face encounters a success the first time around.
June 25 | Review Choice Demonstration
The Centers for Medicare and Medicaid Services (CMS) has set May 2020 as the start date for Review Choice Demonstration (RCD) in North Carolina. This means you have choices to make for how you want it to work for you. AND you have preparations to make to ensure your payments aren’t delayed because of documentation that isn’t approved quickly. We’ll get into details of how RCD and PDGM can work together successfully. Many providers in Illinois, who have had RCD in their lives for quite some time, say they like the program. It gives them a chance to receive education to know what isn’t quite up to par and a chance to get it right the first time.
6 Nurse Contact Hours Offered
The Association for Home and Hospice Care of North Carolina is approved as a provider of nursing continuing professional development by the North Carolina Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.
Instructor: Sandy Decker, RN, BSN
Vice President Home Health Regulatory and Clinical Affairs
AHHC of NC and SCHCHA
A registered nurse since 2005, Sandy received her RN and BSN degrees along with a degree in marketing. Sandy has most recently worked for CGS Administrators, a Medicare Administrative Contractor, as a Senior Provider Education Consultant, where she educated home health and hospice providers on Medicare home health and hospice clinical regulations, Patient Driven Groupings Model (PDGM), and Targeted Probe and Educate (TPE). Sandy performed medical chart review, analyzing information provided by the home health and hospice providers, and their staff and physicians using criteria set by Medicare standards and clinical guidelines.
Sandy also provided educational sessions with PGBA staff in the early days of Pre-Claim Review before it became Review Choice Demonstration (RCD). At CGS, Sandy was a Medical Reviewer with both Medical Review and Appeals before her educator position. She has presented at both national and state conferences for both hospice and home health for many years. Sandy has also been a paralegal and business analyst in both Iowa and North Carolina.
Prior to CGS, Sandy was a Clinical Supervisor, an RN case manager, and served in many capacities at hospice & home health agencies in Iowa. She also has experience as an adjunct Professor at the Iowa nursing college where she received her degrees.
As part of her role as Vice President of Home Health Clinical & Regulatory Affairs, Sandy serves as: key contact for home health clinical and regulatory questions; a content expert and educator for AHHC/SCHCHA conferences, workshops & webinars; representative of AHHC/SCHCHA at Palmetto GBA 16-State Coalition meetings; and liaison to the home health teams at NAHC and Palmetto GBA on behalf of members.