Course Code: REL-PAC-0-HAB
Hours: 1
Type: Online Course
Content Expiration Date: 12/31/2025
Learning Objectives:
Describe the hospice reimbursement system and explain at least two 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 Payer Verification
Medicaid Payer Verification
Commercial Payer Verification
Verification Findings
Medicare Hospice Admission and Billing
Notice of Election
Medicaid Hospice Admission
Commercial Insurance Hospice Admission
Billing Goals for Hospice Admission
Review
Summary
Section 3: Be Proactive
Tools to Facilitate Effective Revenue Cycles
Benefit Periods and Face-to-Face Encounter
Choice of Attending Physician
Plan of Care
Service Intensity Add-On Payments
Appropriate Use of the Levels of Care
Ongoing Hospice Clinical Eligibility
Live Discharges and Revocations
Deaths
Transfers
Residents of Nursing Facilities
Hospice Patients as Residents in Nursing Facilities
Review
Summary
Section 4: 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 5: Conclusion
Course Summary
Course Contributor
Resources
References
Subject Matter Expert: Melinda Diaz, BS, RN, LHRM, CHPN, CHPCA
Melinda is a Hospice and Palliative Care nurse executive with over 41 years of experience in healthcare. She has worked with for-profit and not-for-profit hospices and is proud to have touched the lives of many patients and families.
Target Audience:
The target audience for this course is: Administrators; Nurses; in the following settings: Hospice.
Relias Learning will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
Relias Learning has a grievance policy in place to facilitate reports of dissatisfaction. Relias Learning will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias Learning at support@reliaslearning.com.
All courses offered by Relias Learning, 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.
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.
Course Delivery Method and Format
Asynchronous Distance Learning with interactivity which includes quizzes with questions/answers, and posttests.