While leadership and management deal with results of Medicare Administrative Contractor (MAC) Targeted Probe and Educate (TPE) reviews, ZPIC/UPIC (Zone Program Integrity Contractor/Unified Program Integrity Contractor) audits, and pending Recovery Audit Contractor (RAC) reviews, the battle for Medicare coverage is won or lost at the clinician level. "If it wasn't charted, it wasn't done" has been around forever but "If it was charted wrong, it won't be paid" is the updated version for home health Medical Review. This presentation covers in-depth 11 key Medicare rules and regulations your staff need to know, need to document, and need to follow so that any Medical Review does not take back the visits and cause financial hardship for your agency. Even experienced staff need to have a clear and present knowledge and integrate these requirements into their charting. How these requirements show up (or don't) in MAC and qualified Independent Contractor (QIC) appeal explanations is discussed to demonstrate the importance of charting these right the first time. Addressing these as part of agency culture is an investment in prevention.
Live session held on 8/7/2018
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