Patient Driven Groupings Model (PDGM) Prep Class in Las Vegas

Patient Driven Groupings Model (PDGM) Prep Class

Patient Driven Groupings Model (PDGM) Prep Class
About this Event
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Course Overview

When it takes effect next year, the Patient-Driven Groupings Model (PDGM) from the Centers for Medicare & Medicaid Services (CMS) will have a major impact on the operations and billing processes of home health agencies. It’s critical that providers prepare for 2020. Get a comprehensive overview of the latest changes with this intensive two-day course presented by expert J’non Griffin. You’ll learn not only the difference between payment models, but also how they relate to coding, billing and OASIS.

Course Outline/Agenda

Day 1

PPS vs PDGM—1.5 hours

Discussion of the major differences between the 2 payment models and how to make sure you are prepared for the shift.

Operations and Finances—1.5 hours

Discover ways to align agency operations under the new payment model. We will discuss proper revenue cycle management and how to get paid in a timely manner, and key performance indicators to monitor. We will discuss billing for the claim in a 2nd 30 day payment period when the patient status may have changed.

Clinical Operations under PDGM—1.5 hours

Discussion of ways to ensure clinical operations are efficient and at the same time, outcomes do not suffer. Discover how to share resources and ideas to cover care without incurring costs.

OASIS under PDGM—1 hour

Look at OASIS items that contribute to the functional payment score, and discover how slight variations will make a difference.

Coding under PDGM—1 hour

Discuss the principle groupings, the type of patients are included in these groupings, and the cost of taking care of these patients vs the reimbursement. We will discuss supply utilization, along with the variations that go along with each clinical grouping. We will also discuss comorbidity subgroups and how certain items will trigger an adjustment in your HHRG, and also may affect your LUPA thresholds. We will discuss the importance of having the documentation to validate that.

Day 2

Defensible Documentation under PDGM—1 hour

The expectation is that ADRs will increase in light of the new payment model. Discuss how you should have defensible documentation to justify not only your utilization, but also your selection of diagnosis.

Coding and OASIS Deep Dive under PDGM—2.5 hours

We will work cases that will show how cases in clinical groups may score out under the PDGM model. This will be a great opportunity for coding and QA staff to work through cases to see the importance of accurate assessment and documentation to maximize your reimbursement under PDGM.

Billing and Coding Overview—1 hour

How will you handle the increased workload…we will discuss options your agency may consider including cross training, hiring additional staff, or outsourcing.

Your Presenters

J'non GriffinJ'non Griffin

RN MHA, WCC, HCS-D, HCS-H, COS-C

AHIMA Approved ICD-10-CM Trainer/Ambassador, President of Home Health Solutions, LLC

Griffin offers home health consulting on many topics including quality assurance and performance improvement, program development, coding and OASIS review, staff education and plan of care compilation. Griffin has experience as a field nurse, director and executive with home health and hospice agencies.

Categories: Conferences & Tradeshows

This event repeats daily for 2 times: