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Moving Mountains 13-part webinar series ~ The Phase 3 ROP & 2019 Reimbursement Changes Planned! LeadingAge WA has continued our partnership with Proactive Medical (that brought you our successful 2018 Phase 2 trainings) to prepare for the next webinar series focused on successfully managing the industry changes taking effect in 2019 including Phase 3 Requirements of Participation and the potential transition of Medicare PPS from RUGs IV to the Patient Driven Payment Model (PDPM).  Our goal is to support Washington SNF’s with substantive education, tools, and resources to implement practical, step-wise action plans for success with the 2019 changes.

Seminar Title:  PDPM Triple Check Process and Billing Accuracy

Presentation Date: October 2, 2019 Live Webinar         
Presented By:

• Shelly Maffia, MSN, MBA, RN, LNHA, QCP, Clinical Consultant

• Amie Martin, OTR/L, CHC, RAC-CT, Clinical Consultant

• Eleisha Wilkes, RN, RAC-CT, Clinical Consultant

Course Description:

This 1.25-hour webinar will review best practices to decrease potential billing errors and promote accurate reimbursement for PDPM claims through internal interdisciplinary auditing processes. Key roles of interdisciplinary team members in completion of a collaborative triple check process and key data collection, billing, and monitoring process pertinent to PDPM will be emphasized.

Learning Objectives:

1. Review best practices for internal audit of PDPM claims prior to submission to decrease potential billing errors and promote accurate reimbursement
2. Identify key roles of the interdisciplinary team in completion of a collaborative triple check process of items/data elements impacting PDPM reimbursement
3. Review key data collection, billing and monitoring processes important to PDPM reimbursement accuracy including but not limited to understanding the updated HIPPS codes and validating UB-04 accuracy prior to submission. 

Course Content:

11:00        Updating internal billing accuracy processes to ensure validation of key PDPM reimbursement criteria

11:15         Roles and responsibilities of interdisciplinary team members in the triple check process

• Administrator, Business Office, Nursing, RAI Nurse Coordinator, Therapy, Medical Records                  

11:45           Understanding updated HIPPs codes

•   Key data validation, billing and monitoring processes
•   Compliance risks & using a QAPI framework to address them                 

Noon           Q&A

12:15           Closing Comments

Target Audience:   Owners and Corporate Teams, Director of Nursing, Assistant Director of Nursing, Nurse Managers, Nursing Home Administrators, Nursing staff and leaders, Quality Assurance Director, Medical Records, MDS staff, Therapy staff, Business Office and Finance

Instructional Level: Intermediate   Contact Hours: 1.25

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