Hospice ADRs
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When: Wednesday, February 7, 2018
11:30 am- 1:00 pm
Where: United States
Contact: Doreen Napoli

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The Centers for Medicare and Medicaid Services (CMS) have the authority to perform pre and post payment medical reviews of hospice Medicare claims.  With an ever increasing focus on fraud, abuse and waste, ADRs (Additional Development Requests) have become a harsh reality for all post- acute providers, including Hospice.  Prepayment reviews have increased at an alarming rate, resulting in payment delays, payment denials and administrative headaches.  This session will help Hospices become proactive and develop strategies to effectively respond to ADRs, in an effort to minimize denials.

Participants will be able to:

·         Define the terms Probe Edit, Additional Development Request and Targeted Medical Review

·         Identify the difference between technical and medical claim denials.

·         List the five (5) levels of appeals, and timelines associated with each level.

·         Identify strategies for managing and responding to ADRs.

·         Identify  practices and scenarios that can potentially trigger an ADR