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Regulations to Records: Compliant Charting
May 12, 2022 @ 2:50 pm – 3:50 pm
Despite the Public Health Emergency’s stresses on home health agency operations, there are multiple Medicare, Medicare Advantage, and commercial insurance reviewers that are checking medical records for accurate claim payment. Compliant clinical record content is key to a successful outcome from a MAC TPE, UPIC, RAC , SMRC or CERT audit. The correct content should be included when the record is generated—not after. This presentation starts with CMS regulations and provides examples for how these should be reflected in the home health record. Linking requirements to known denial reasons will show how proper documentation can avoid a negative outcome. This provides the basis for staff education. The items covered also apply to Medicare Advantage medical reviews.
Joe Osentoski, BAS, RN-BC has over 25 years in home health and hospice with a specialty in clinical quality assurance and regulatory compliance. This includes experience with all types of Medicare contractors, Medicare Advantage plans, and commercial payers related to probes, audits, reviews, denials, and appeals.