Details matter. Medical review denials most often occur because the medical records do not clearly demonstrate the patient's eligibility for hospice care. This program will explore the top five denial reasons, how to react to an audit, and your appeal rights. Take your documentation from good to great and avoid those pesky, time-consuming denials.

AFTER THIS WEBINAR YOU’LL BE ABLE TO:

• Distinguish between the different types of medical review audits
• Identify the steps in the appeals processes
• Understand the financial impact of claim denials
• Explain the top reasons for medical review claim denials
• Reduce risks of claim denial with defensible documentation

WEBINAR DETAILS: What is a medical review and are you prepared for it? Hospices across the country are facing focused scrutiny for program integrity, which involves medical review audits. This webinar will walk through the top five medical review denial reasons that agencies are facing today. You will learn how to respond to a medical review audit with a firm understanding of your appeal rights. It will also address strategies for improving documentation to ensure compliance with the conditions of payment.

THIS WEBINAR WILL BENEFIT THE FOLLOWING AGENCIES: Hospice

WHO SHOULD ATTEND? This informative session is designed for nursing directors, administrators, clinical managers, and RN case managers.

TAKE-AWAY TOOLKIT

• Website links for education and training resources
• Training log
• PDF of slides and speaker’s contact info for follow-up questions
• Attendance certificate provided

DON’T MISS THIS RELATED WEBINAR!

Denial: Misdiagnosed & Misunderstood on Thursday, June 5, 2025

NOTE: All materials are subject to copyright. Transmission, retransmission, or republishing of any webinar to other agencies or those not employed by your agency is prohibited. Print materials may be copied for eligible participants only.

MEET THE PRESENTER: Tammy Stewart,RN, CPHQ, COS-C, Clinical Consultant, Healthcare Provider Solutions

Tammy Stewart is a registered nurse who joined Healthcare Provider Solutions, Inc. (HPS) as a clinical consultant in August 2021. Tammy’s commitment to service and compassionate nursing care started over 30 years ago when she began as a home health nurse. She has also worked as a hospice nurse providing care to patients in their home and in general inpatient (GIP) settings. Tammy is a member of the National Association for Healthcare Quality and the American Society for Quality. She is a Certified Professional in Healthcare Quality (CPHQ) and is a certified consultant for Community Health Accreditation Partner (CHAP) and Accreditation Commission for Health Care (ACHC). In addition, she is a Certified OASIS Specialist (COS-C). As a part of the HPS clinical consulting team, Tammy provides support and solutions to home health and hospice agencies nationwide to achieve regulatory compliance. Her experience includes developing and implementing quality assurance and performance improvement programs (QAPI) for home health and hospice agencies in addition to performing data analysis, clinical chart reviews, onsite billing audit reviews, and provider education.