Additional Developmental Reviews (ADR) & Denials: Strategies for Home Health Agencies - On-Demand
Thursday, October 20, 2016
Original Broadcast Date:
Thursday, May 12, 2016
Joan L. Usher, BS, RHIA, COS-C, ACE, AHIMA-Approved ICD-10-CM Trainer
Level of Program
Basic to Intermediate
Additional Development Requests (ADR) require deadline-driven action and further burden home health agencies already inundated with day-to-day operations. Understanding which documentation is necessary and how to properly organize it greatly improves your chances of avoiding ADR denials, which affect reimbursement.
During this program, expert speaker Joan L. Usher, BS, RHIA, COS-C, ACE, will discuss current issues that trigger ADRs and explain how to successfully manage ADRs for a denial-free medical review.
At the conclusion of this on-demand program, participants will be able to:
- Identify the current issues that trigger ADRs
- Discuss the necessary steps to submit documentation on time and avoid having claims denied
- Identify three strategies for managing ADRs/denials effectively
Who Should Listen?
- Home health administrators and directors
- Nurse managers
- Documentation specialists
- Quality improvement directors
- Agency administrators
- Billing managers
- Long-term care administrators and directors
- Current issues that prompt ADRs
- Tips for dealing with an ADR
- Answers to FAQs about ADRs
- Key documents that need to be sent
- ADR review process and timeline
- Time frames for submission
- Strategies for submitting the right information
- Reviewing the pre-billing edit process and what it should include
- Understanding the differences between types of medical review requests (i.e., probes, CERT)
- Medicare Program Integrity Manual
- Benefits and drawbacks of Electronic Submission of Medical Documentation (esMD) versus mail/fax
- Understanding the appeal process when a claim is denied
- Common ADR denials
- Steps in the appeals process and timelines
- Q&A (not live)
Nursing Contact Hours (ANCC)
HCPro is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
This live educational activity for 1.5 nursing contact hours is provided by HCPro.
Meet the Speaker
Joan L. Usher, BS, RHIA, COS-C, ACE, AHIMA-approved ICD-10-CM trainer, is the president of JLU Health Record Systems in Pembroke, Massachusetts. Usher is a nationally recognized expert in the field of coding and health information management. Her career began at a visiting nurse association, and she has been consulting for more than 25 years. Usher has been a certified OASIS specialist in the clinical realm for over nine years and co-authored The How-To Guide to Home Health Billing and ICD-10 Coding for Home Health: A Guide to Medical Necessity and Payment. She works with home health agencies and hospices on ADR, denials, and appeals. Usher has presented materials on home health documentation, denials, and appeals for the Home Care Alliance of Massachusetts and other New England homecare associations.
Webinar system requirements and program materials:
To fully benefit from the webinar experience, please note you will need a computer equipped with the following:
Internet: 56K or faster Internet connection (high-speed connection recommended)
Streaming: for audio/video streaming, Adobe Flash plug-in or Safari browser on iOS devices
Prior to the webinar, you will receive an email with detailed system requirements, your login information, presentation slides, and other materials that you can print and distribute to all attendees at your location.
COULDN'T LISTEN LIVE?
No problem. The On-Demand version is also available. Use it as a training tool at your convenience—whenever your new or existing staff need a refresher or need to understand a new concept. Play it once or dozens of times. A $199 value!
Participation in this webinar is just $199 per site. All materials must be retrieved from the Internet.
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