Hot Topics in Hospice, RAC, ZPIC & MIC Audits & Appeals

Posted on January 16, 2016

Date/Time: 01/16/2016, 10:00 am - 4:30 pm

Provider: Florida Hospice and Palliative Care Association

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Thursday, January 7, 2016

10:00 am – 11:30 am HST
11:00 am – 12:30 pm AKT
12:00 pm – 1:30 pm PT
1:00 pm – 2:30 pm MT
2:00 pm – 3:30 pm CT
3:00 pm – 4:30 pm ET

Navigate through appeals and win. Appeal procedures for Medicare, Zone Program Integrity Contractors (ZPIC), Recovery Audit Contractors (RAC), and Medicaid Integrity Contractors (MIC) are a mine field. How should a provider respond to these audits? What happens when the audit is over? What hot topic issues are auditors watching? What are the appeal procedures and deadlines? Is settlement possible?

HIGHLIGHTS

RAC, MIC, and ZPIC entities, their authorities, and audit processes
Appeals process and tips for winning Medicare, RAC, ZPIC, and MIC appeals
Identify common issues that are the subject of hospice audits and appeals and how to respond
Compliance strategies to challenge a denial at any level of appeal and prevent future denials

TAKE-AWAY TOOLKIT
- CMS, OIG, ZPIC, RAC, and MIC guidances

WHO SHOULD ATTEND?

This informative session is designed for management, clinical, billing, and marketing staff.

PLEASE NOTE
Webinar content is subject to copyright and intended for your individual organization’s use only.

MEET THE PRESENTER

Connie A. Raffa
Arent Fox LLP

Connie Raffa

Learn more HERE.

News

Corporate Patron Member Spotlight

Florida Hospice and Palliative Care Association thanks our NEW Corporate Patron members as of May 2023! Thanks for supporting the mission of FHPCA and hospice programs in Florida! To learn more on how to become a Corporate Patron member click…

Upcoming Events

Today

Sun

Mon

Tue

Wed

Thu

Fri

Sat

12:00 PM - Mock Surveys & Continued Readiness Part 1 for Home Health & Hospice

12:00 PM - Critical Skills for Volunteers: Boundaries, Suicide Intervention, Grief & Loss

12:00 PM - Looking Under the Hood: Fine Tuning Your Operating Model

12:00 PM - Compliance for the Hospice Bereavement Team

12:00 PM - Record Retention Rules for Hospice & Home Care Providers

12:00 PM - How to Operate a Hospice Inpatient Unit & Remain Financially Sound

12:00 PM - Hospice by the Numbers: Public Reporting & the Pursuit of Quality

12:00 PM - Mock Surveys & Continued Readiness Part 2 for Home Health & Hospice

12:00 PM - Beyond Hearing: How Active Listening Drives Success (Complimentary)

12:00 PM - How to Effectively Audit Hospice Documentation

12:00 PM - Hospice Medical Review in a Medicare-Certified World

Mock Surveys & Continued Readiness Part 1 for Home Health & Hospice

04/03/2024

12:00 pm

Webinars

Part 1 of the series will focus on understanding the regulations, the types of deficiencies, including condition level deficiencies and immediate jeopardy, and how to avoid them. It will also drill down on regulatory compliance, including how to prioritize noncompliant areas, assess your agency, write action plans, involve and educate staff, and develop an effective QAPI program. There will be a brief review of the data-driven information on Care Compare, CAHPS, etc. to explain how to tie those into your QAPI program to ensure compliance and enhance quality and efficiency of care.

More Info

Critical Skills for Volunteers: Boundaries, Suicide Intervention, Grief & Loss

04/04/2024

12:00 pm

Webinars

After completing training, your volunteers should be fully prepared for the work they face. Most programs utilize a standardized curriculum that meets Medicare guidelines, yet those topics are meant to be “minimum standards” and miss some very important issues and necessary skills. This webinar will explore several critical skills, including setting and maintaining personal and professional boundaries, the critical importance of supervising volunteer boundaries, volunteers’ part in suicidal ideation intervention, their role in assessing and providing grief and loss support and guidance, and other important dynamics.

More Info

Looking Under the Hood: Fine Tuning Your Operating Model

04/09/2024

12:00 pm

Webinars

Your operating model is a three-legged stool: providing care, business development (patient acquisition), and financial performance. Each leg is comprised of many systems and procedures. How well these systems and procedures function drives performance throughout the organization. With this webinar, you’ll learn the essential elements of each leg. More importantly, you’ll be able to identify the means and methods to improve the systems and procedures that support these critical elements. You’ll walk away with practical approaches to strengthen your operating model, serve more people, and grow.

More Info

Compliance for the Hospice Bereavement Team

04/10/2024

12:00 pm

Webinars

Part 5 of this five-part compliance series will review the CoP requirement for bereavement counseling as a core hospice service. It will cover key regulations for bereavement care and provide recommendations for best and preferred practices and program structure. Who is qualified to provide these services? Who will receive these services? Setting up a bereavement plan of care as well as how to implement and measure your bereavement program for effectiveness will be addressed. Bereavement care is not just something a hospice agency implements upon death. It requires ongoing assessments, and many agencies fall short. This webinar will identify all areas where bereavement risk can be identified, discussed, and addressed.

More Info

Record Retention Rules for Hospice & Home Care Providers

04/11/2024

12:00 pm

Webinars

Mismanaged, misplaced, or missing medical and business records are more than a nuisance. They are a liability. You are required to preserve, protect, produce, and purge records, including PHI, EPHI, personally identifiable information (PII), and other business-critical information in compliance with HIPAA, federal legislation, state data breach notification laws, and e-discovery guidelines. Best practices call for strategic records management programs, complete with comprehensive records retention policy and procedures. Failure to safeguard PHI and EPHI could lead to HIPAA investigations, financial penalties, and disgruntled patients. Mismanagement of business records, including PII and electronically stored information (ESI), could trigger costly lawsuits, damaged reputations, and decreased revenues. Attend this program to learn best practices-based strategies for effective records management. You’ll leave with a package of valuable tools, including a sample records retention policy, record retention guidelines, and an informative whitepaper to help your organization manage records, minimize risks, and maximize compliance.

More Info

How to Operate a Hospice Inpatient Unit & Remain Financially Sound

04/16/2024

12:00 pm

Webinars

This webinar will provide an understanding of the fundamental principles for operating hospice inpatient units and delve into the core elements that form the bedrock of operational success, emphasizing the significance of strict discipline and focus. It will explore the operational strategy for a general inpatient unit, dissecting key components such as staffing, training, patient-centered care, and integration with other care levels. Real-world case studies will provide insights into successful implementation.

More Info

Hospice by the Numbers: Public Reporting & the Pursuit of Quality

04/23/2024

12:00 pm

Webinars

If you work in a hospice environment long enough, you will hear a bunch of acronyms related to quality scores. Ones like HQRP, HIS, CAHPS, and SHP, for example. For those who are not quality improvement professionals but who work in this area every day, retaining and understanding all this information can seem daunting. This webinar will break down and explain the components of quality scores and explore how access to and understanding of this data can lead to quality improvement that is patient and family centered and effective.

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Mock Surveys & Continued Readiness Part 2 for Home Health & Hospice

04/24/2024

12:00 pm

Webinars

You’ll learn how to survey the EP program and QAPI, including how to tie information from the QAPI program to what is found on home visits and in records. Discover what to look for in staff education, competency, and personnel files, how to interview staff and managers, and the specifics on how to include a home visit in a survey. This program will address how to review clinical records with particular attention to common deficiencies.

More Info

Beyond Hearing: How Active Listening Drives Success (Complimentary)

04/25/2024

12:00 pm

Webinars

In this engaging webinar on active listening, participants will explore the profound impact of this crucial communication skill in the workplace. Through examples and practical techniques, the session will highlight how active listening fosters better understanding, strengthens team dynamics, and enhances overall collaboration. Attendees will gain valuable insights into how mastering active listening can lead to improved problem-solving, increased productivity, and a more positive and inclusive work environment.

More Info

How to Effectively Audit Hospice Documentation

05/01/2024

12:00 pm

Webinars

Hospice documentation should paint a very clear picture of a patient’s eligibility from admission through discharge. Many agencies are surprised to learn their poor documentation does not support eligibility when suddenly tasked with an “additional documentation review” and recoupment of Medicare dollars. This presentation will explain how to effectively audit hospice documentation, review the highest-ranking focus areas, and address what should appear on every hospice documentation audit tool. From technical requirements to clinical requirements, this presentation will take you through an effective hospice documentation audit step-by-step. It will also describe how to identify areas of risk so they can be incorporated into performance improvement.

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Hospice Medical Review in a Medicare-Certified World

05/02/2024

12:00 pm

Webinars

While billing the Medicare benefit and getting paid is relatively easy, there is always a risk of review and denial. Webinar participants will learn to define and outline the response to any level of medical review, including TPE, UPIC, RA, SMRC, and OIG audits. This session will also cover the data analysis agencies need to review to ensure their medical review risk is limited. Don’t be caught in the position of believing that everything is okay. This session will also cover the new Special Focus Program (SFP) for poor performers. Attendees will learn how to ensure their documentation is accurate and will be able to successfully endure medical review of their charts.

More Info

Events on 04/03/2024

Mock Surveys & Continued Readiness Part 1 for Home Health & Hospice

3 Apr 24

Events on 04/04/2024

Critical Skills for Volunteers: Boundaries, Suicide Intervention, Grief & Loss

4 Apr 24

Events on 04/09/2024

Looking Under the Hood: Fine Tuning Your Operating Model

9 Apr 24

Events on 04/10/2024

Compliance for the Hospice Bereavement Team