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QAPI for Outcomes and Compliance: Including Both Conditions of Payment and Participation

Product Code: YPADA071718A

Quick Overview

Join us for a one-hour comprehensive webinar and learn how to stop confusing a billing audit with a QAPI program. Our experts will teach you about the top triggers CMS uses when it examines your agency’s OASIS submissions—and how you can avoid being a target.

Price: $249.00

QAPI for Outcomes and Compliance: Including Both Conditions of Payment and Participation

QAPI for Outcomes and Compliance: Including Both Conditions of Payment and Participation

Presented on:
Tuesday, July 17, 2018
1:00-2:00 p.m. Eastern

Presented by:
Michael McGowan
Kristi Bajer, BSN, RN

Level of Program:
Intermediate

Agencies are often blindsided with additional documentation requests (ADRs) and claim denials, despite high marks on surveys. That’s because they are auditing from accrediting guidelines, not CMS triggers.

Join us for a one-hour comprehensive webinar and learn how to stop confusing a billing audit with a QAPI program. Hear directly from a former state/CMS Region IX OASIS coordinator and a former regional director who facilitated multiple successful Joint Commission accreditation surveys. Together, these experts will teach you about the top triggers CMS uses when it examines your agency’s OASIS submissions—and how you can avoid being a target. You’ll also learn the importance of the Conditions of Payment.

This detailed webinar will help you:

  • Understand why a good survey does not protect you against audits
  • Learn how to stop confusing a billing audit with a QAPI program
  • Prepare for success in advance of CMS launching a claim review demonstration in five states (Florida, Illinois, North Carolina, Ohio, and Texas)
  • Consider the importance of using data to drive patient care
  • Learn how compliance will improve your QAPI program and patient outcomes
  • Understand that while agencies might be focused on complying with the revised home health Conditions of Participation, they also must understand the importance of the Conditions of Payment

Agenda 

  • Analyze the many things agencies do that trigger ADRs from CMS contractors 
  • Examine what language to avoid documenting because it will serve as a target for claims reviewers 
  • Review what reports to investigate to determine whether your agency may be a target for claims reviewers — and learn what to look for within those reports 
  • Describe how to make objective, consistent OASIS submissions 

Who Should Listen? 

  • Agency owners 
  • Administrators 
  • Clinical managers 
  • Quality mangers 
  • Compliance officers 
  • RNs and PTs 

Your Expert Presenter

Michael McGowanMichael McGowan, a former state/CMS Region IX OASIS coordinator, is a longtime homecare consultant. He is currently president of OperaCare in Socorro, New Mexico. OperaCare utilizes proactive OASIS analytics and systematized processes to exploit the entirety of home health payment models—establishing financial predictability, eliminating after-hours charting, minimizing additional documentation requests (ADR) and audit risks, and monitoring OASIS outcomes. McGowan is a regulatory expert in ZPICs, ADRs, and medical review.


Kristi Bajer, BSN, RNKristi Bajer, BSN, RN, started in homecare as a registered nurse case manager. Over the last 10 years, she has been a director of nursing, an administrator, and most recently a regional director over six agencies in Texas. As a regional director, she facilitated multiple successful Joint Commission accreditation surveys, including surveys without citations or recommendations. Bajer helped design programs for the top DRGs in her service area, drastically decreasing readmissions and increasing referrals. Today, she assists agencies with external chart audits and Medicare appeals, as well as providing training and coaching on OperaCare.