PDGM Structure & Financial Impact: Monday, December 2
This webinar will take the agency through an introduction to the PDGM structure and the essentials to understand as the webinar series progresses. From the creation of a HHRG, the corresponding case‐mix weight and how the determination of a Low Utilization situation might be reviewed, the agency will get a foundation of all that is PDGM. There will also be a review of the financial estimates that CMS has made and a review of the effect that PDGM will have on cash flow.
PDGM Coding & OASIS Integrity: Tuesday, December 3
ICD‐10‐CM coding will be the ONLY source for both grouping your patient into the Clinical Grouping of the PDGM system, but it will also effect the Comorbidity adjustment. This webinar will explore the list of acceptable primary diagnoses that has been published as the list for PDGM and outline the process of establishing the comorbidity adjustments. Key things to look for and a plan of action will be discussed as agencies begin preparation for PDGM. A review of how the Functional Impairment calculation for the HHRG under PDGM will be the only financial change driven by OASIS responses and the significance of accurate OASIS data.
PDGM Operational Decision Necessities: Wednesday, December 4
This webinar will discuss case management of patients under PDGM and the impact on cost, outcomes, etc. that this will impact. There will also be deep dive into the removal of the therapy thresholds, that are existent under PPS, and The LUPAs levels will be discussed and comparisons and analogies will be laid out regarding the LUPA under PPS and what the LUPA will look like under PDGM.
PDGM Revenue Cycle Changes: Thursday, December 5
The billing volume for 75% of the current Medicare episodes is likely going to DOUBLE under PDGM. With RAPs and Finals being required every 30 days instead of 60, agencies may need to expand their Revenue Cycle teams. This webinar will cover details that are available at the time, regarding the actual billing changes that will need to occur under PDGM. There will also be a discussion of the overall impact on the revenue cycle under PDGM.
Melinda A. Gaboury is co-founder and Chief Executive Officer of Healthcare Provider Solutions, Inc. (HPS).
Melinda has profound experience in Medicare PPS training, billing, collections, case-mix calculations, chart reviews and due diligence. ZPIC, RA, ADR & TPE appeals with all Medicare MACs have become the forefront of Melinda’s current impact on the industry.
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