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.
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.
Provider approved by the California Board of Registered Nursing, CEP# 13791
Nurses will receive 1.25 contact hours for participating in this course.
In support of improving patient care, Relias LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
District of Columbia Board of Nursing Approved Continuing Education program (CEBroker Provider #50-290).
Florida Board of Nursing (CEBroker Provider #50-290)
Georgia Board of Nursing (CEBroker Provider #50-290)
South Carolina Board of Nursing (CEBroker Provider #50-290)
West Virginia Board of Registered Nursing (CEBroker Provider #50-290)
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
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, BSN, RN, CHPN
Susan Heinzerling earned a Bachelor of Science in biology and a Bachelor of Science in nursing from the University of North Carolina at Chapel Hill as well as a Master of Life Sciences in physiology from North Carolina State University. She became a doctoral candidate in immunology at the University of South Alabama. Her research experiences in the biomedical sciences led to an interest in evidence-based practices. Ms. Heinzerling began her nursing career as a medical/surgical nurse. Renal patients in acute care with multiple chronic conditions and repeated hospitalizations inspired her practice of hospice nursing. She has worked as a hospice admissions nurse and a hospice RN case manager in both a large urban setting and a rural community. Disclosure: Susan Heinzerling, BSN, RN, CHPN has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Access to over 1,450 courses! Access to 1,450+ courses for one low price.