Business of Hospice

Business of Hospice 

As healthcare reimbursement is evolving, the need to manage the financial side of the hospice organization becomes even more critical for survival. This course provides an overview of running a hospice as a business. It outlines how hospices are reimbursed and cost management strategies.



$15.00

Hours: 1.25
REL-HOS-0-BH-V3

Certificates

Certificates provided by accrediting body (7 Match)

California Board of Registered Nursing

1.25 HOURS


Provider approved by the California Board of Registered Nursing, CEP# 13791

Nurses will receive 1.25 contact hours for participating in this course.

American Nurses Credentialing Center

1.25 HOURS


Relias, LLC is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Nurses will receive 1.25 contact hours for participating in this course.

District of Columbia Board of Nursing

1.2 HOURS


DC-RN -- District of Columbia Board of Nursing Approved Continuing Education program (CE Provider #50-290).

Nurses will receive 1.20 contact hours for participating in this course.

Florida Board of Nursing

1.0 HOURS


Florida Board of Nursing CE Provider #: 50-290

Nurses will receive 1.00 contact hours for participating in this course.

Georgia Board of Nursing

1.25 HOURS


Georgia Board of Nursing CE Provider #: 50-290

Nurses will receive 1.25 contact hours for participating in this course.

South Carolina Board of Nursing

1.25 HOURS


This program was approved by the South Carolina Board of Nursing Approved Continuing Education Program (CE provider #50-290) CE Broker Course # 20-[Custom_Code]

West Virginia Board of Registered Nursing

1.25 HOURS


Course Details

Course Code: REL-HOS-0-BH-V3
Hours: 1.25
Type: Online Course
Content Expiration Date: 4/30/2022
Learning Objectives:
Describe the hospice reimbursement system in the context of the AR billing cycle.
Illustrate at least 2 ways to submit clean claims to reduce denials.
Recall sources of revenue for hospice, including insurances, private pay, and donations.
Identify how to balance cost and quality while maintaining cost containment.

Outline:
Section 1: Introduction

About This Course

Learning Objectives

Section 2: Foundations for Success

Hospice Business Success

The Referral: Insurance Eligibility and Verification

Medicare Payor Verification

Medicaid Payor Verification

Commercial Payor Verification

Communicating Verification Findings

Review

Summary

Section 3: From Hospice Referral to Hospice Admission

Medicare Hospice Admission and Billing

Notice of Election

Medicaid Hospice Admission

Commercial Insurance Hospice Admission

Billing Goals for Hospice Admission

Review

Summary

Section 4: Be Proactive

Tools to Facilitate Effective Revenue Cycles

Certification of Terminal Illness

Benefit Periods and Face-to-Face Encounter

Choice of Attending Physician

Plan of Care

Appropriate Use of the Levels of Care

Evaluate Ongoing Hospice Clinical Eligibility

Service Intensity Add-Ons

Revocations and Live Discharges

Deaths

Transfers

Hospice Patients as Residents of Nursing Facilities

Review

Summary

Section 5: Hospice Service Structure and Coding

Levels of care

Service Intensity Add on Payments

Revocations and Live Discharges

Transfers

Deaths

Hospice Patients as Residents in Nursing Facilities

Residential Patients in Hospice Facilities

Review

Summary

Section 6: The Hospice’s Financial Health

Successful Billing Processes Bring Revenue

Successful Billing: Minimize AR Aging

Medical Expenses for the Hospice Patient

Hospice Supplemental Income

Review

Summary

Section 7: Conclusion

Summary

Course Contributors

Resources

References

Instructor: Hilda Kee, BA Organizational Management
Hilda Kee has had well-rounded experience in the financial aspect of the healthcare industry.   Hilda's entire career path has allowed her the opportunity to assist with monitoring, management and development of organizational processes of the business operations related to medical care.  She has worked for insurance companies, hospital and other medical facilities, revenue cycle management companies and now hospice. This has given Hilda the opportunity to become well-versed in insurance benefit language at different levels of the industry, including the claims review process, and creation and compliance of contract terms between providers and insurance to accomplish revenue cycle management expectations. Disclosure: Hilda Kee, BA Organizational Management has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Staff Writer: Susan Heinzerling, RN, CHPN
Susan Heinzerling began her nursing career as a Med/Surg nurse. Renal patients in acute care, with multiple chronic conditions and repeated hospitalizations inspired her practice of hospice nursing where she began as Hospice Admissions Nurse and later became a Hospice RN Case Manager. Susan has practiced hospice nursing in both a large, urban area and in a rural setting. Susan earned a B.S. in Biology and B.S. in Nursing from the University of North Carolina at Chapel Hill and a Master's degree in Physiology from North Carolina State University. She became a Ph.D. Candidate in Immunology at the University of South Alabama. Her research experiences in the biomedical sciences led to an interest in evidence-based practices. Disclosure: Susan Heinzerling, RN, CHPN has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Target Audience:
The target audience for this course is: Nurses; in the following settings: Hospice.
Relias will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
Course Delivery Method and Format
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
Relias has a grievance policy in place to facilitate reports of dissatisfaction. Relias will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias.
If you require special accommodations to complete this module, please contact Relias Support by completing the web form (https://www.relias.com/help) or by using the chat functionality.
All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
Reference herein to any specific commercial product, process, or service by trade name, trademark, service mark, manufacturer or otherwise does not constitute or imply any endorsement, recommendation, or favoring of, or affiliation with, Relias, LLC.
All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Accommodations
If you require special accommodations to complete this module, please contact Relias Customer Support here.