8:00 – 9:00 a.m.
9:00 – 10:00 a.m.
Ernesto Moreno, MBA, BSN, CHCA, CPC, vice president of home care, Interim Healthcare of Upstate
Find out how this veteran rev cycle strategist achieved profitability and increased average revenue per episode by $800 while maintaining quality for his agency. He’ll uncover how patients’ clinical, functional and service scores can serve as a powerful tool to drive medical necessity, revenue, utilization and compliance decisions. Discover the importance of tracking OASIS accuracy, true functional scores, utilization (discharges within 30 days) and patients with multiple disciplines.
TOOLS Understanding the CFS algorithm and different KPIs under PDGM
10:00 – 10:20 a.m.
10:20 a.m. – 11:20 a.m.
Arron Little, managing director at BKD
Develop more efficient billing practices to keep pace with PDGM’s shorter billing cycles. Discover how you can decrease the time to submit RAPs and final claims while maintaining compliance. Get insights into how PDGM is impacting day-to-day operations, how to eliminate unnecessary orders, what to include on intake forms and how to conduct effective billing audits. Plus learn about often overlooked issues and how to address them.
TOOLS Sample billing audit tool and intake form
11:20 – 12:20 p.m.
12:20 – 1:20 p.m.
Dr. Dea Kent, Innovative Leader, Dea Kent Consulting; and director of risk management, Community Health Network
Become an agency recognized for its excellent wound care, and you’ll increase your referrals and PDGM reimbursements for these patients. Get steps for developing a cost-effective wound care program under PDGM including how to staff it, market it and use new technologies and treatments to heal patients faster. Set up wound/skin integrity policies, cost-effective treatment plans and supply formularies and document to avoid audit risks down the road.
TOOL Sample formulary with guidelines for use
1:30 – 2:30 p.m.
Sharon Harder, president, C3 Advisors; and AHCC board member
PDGM will bring a host of new compliance issues that must be proactively addressed by agencies. As medical review becomes even more subjective in 2020, agencies will need to fully understand the new rules, how they affect agency operations and the revenue cycle and how to ensure that the conditions of payment are being consistently met. This session will investigate new compliance requirements and what agencies must do to be fully compliant in 2020 and beyond.
TOOL Compliance review tool
2:30– 2:50 p.m.
2:50 - 3:50 p.m.
Carissa Mckenna, senior clinical consulting manager, McBee Associates
Both your clinical and case managers play an increasingly important role in PDGM. During this session get a big-picture look at how to optimize the roles. Empower your clinical managers to manage expenses by impacting retention, care management, supply management and productivity. Simultaneously enable clinical managers to coordinate with their case managers, liaisons, intake and scheduling personnel to improve efficiencies and achieve better outcomes. This coordination is crucial to increase referrals from institutions, improve OASIS competency that will drive better coding, boost productivity with better documentation processes, and drive the right staffing and resource use under PDGM.
TOOLS Outline of expertise and required skills for clinical managers and case managers
4:00 – 5:00 p.m
Sherri Parson, RN, HCS-D, HCS-O, COS-C, BCHH-C, HSC-H, vice president of education and control standards, Quality in Real Time (QIRT)
Improve your primary diagnosis error rate, the quality of care you provide, the accuracy of your reimbursement and the delivery of care with one project. Through analytics and the process of Plan Do Study Act (PDSA), QIRT developed and implemented multiple improvement projects that improved primary diagnosis error rates
Get a step-by-step guide for putting a plan like this in place at your agency and achieving this same success.
TOOLS Scoring rubric for primary diagnosis
5:00 – 6:30 p.m.