FRIDAY July 8, 2016:
“Preview of the Pre-Claim Review Demonstration for Home Health Services“
Learn How CMS Plans to Reduce
a 59% Error Rate
And we discuss: is this a view of the future?
Sponsored by The Health Law Partners, MAS Coding Solutions
THIS WEEK, we invited a clinical consultant to join us, Joe Osentoski, BAS, RN-BC, from A.D. Maxim Consulting. He has worked for 20 years as a clinical consultant in home health and hospice, and has extensive experience with multiple Medicare audits, pre-pay probes, compliance audits and targeted medical reviews. He has completed over 5,000 Additional Development Requests (ADR’s) in home care and hospice, filed 1000’s of appeals, and has had more than 1,000 claims resolved at the ALJ level, with a 90% success rate.
Joe comes to us via reference of Former ALJ Bob Soltis, a veteran of our shows. Joe appeared before Judge Soltis on many occasions and impressed the Judge with his knowledge, preparedness and straight-shooting style.
We asked Joe and Judge Soltis to come speak with us about CMS’ new Pre-Claim Review Demonstration of Home Health Services, just announced on June 8 2016. A quick look at the project may give you chills, realizing that CMS might find this a more successful model for reducing denials and appeals than any other planned projects. And if it does succeed, what might that mean for hospitals, and not just Home Health Agencies?
So here’s what we will be discussing on our show:
- A short review of what the Demonstration does for Home Health Agency processes
- Are there any regulatory changes?
- Will this really help the OMHA Backlog, as CMS claims?
- Is this “the same ol’ same ol'” manual review process?
- Will this really be more of a help or a hinderance?
So join us, share your own insights and bring your questions for us!
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FRIDAY – 1:00PM to 2:00PM EDT
AHA v. Burwell - Reply Memo in Support of Motion to Stay - Filed 07/01/16 95.34 KB 28 downloads...
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