Presented by Peggy Porter-McGee

Overview:

Your hospice agency’s claims are required to list Attending Physician information. New regulation effective June 3, 2024 requires that the Hospice Attending Physician must be enrolled in PECOS or Opt-out. CMS has identified certain criteria for claims process purposes to avoid denials. Transitioning time frame begins with claims containing Dates of Service June through October. Claims after this time frame will follow different criteria.

Hospice Agencies must confirm that the Attending Physician/Referring Physician are PECOS or Opt-Out enrolled and understand the consequences of payment should the claim report an Attending/Referring/Hospice Physician that is non-PECOS. Learn the steps needed to update the current patients and adhere to the rule for future patients.

Objectives:

• Understand Hospice Regulatory requirements.
• Identify data to track.
• Learn effective systems to put in place to keep you on track.
• Detect claims that contain Physicians that will cause denials.

Speaker Biography:

Peggy Porter-McGee is a Revenue Cycle Management Expert, who works as a SME to support RCM operations, oversight, efficiency and improvement. Peggy’s experience and knowledge in Hospice and Home Health Revenue Cycle Management began in 1987.  Her health service RCM also includes Long Term Acute Care Hospital Business Office Manager, DME and Palliative Care billing and collections. Serving as RCM for multi-state Hospice/Home Health organization allowed expansion of knowledge of all MAC’s (Medicare Administrative Contractors), State Medicaid programs, as well as insurances and unique credentialling processes of each. This combined experience brings a unique ability to depend on previous knowledge to quickly develop tool sets to address nuances required by payers.  Keeping abreast of regulatory releases, Peggy has provided methods to incorporate compliance from intake through discharge to ensure that each claim was compliant and above scrutiny.

She has joined projects for startup, acquisition and assimilation of home health and hospice agencies during her career which affords a skill set that include due diligence, implementation, training and follow-up support of the agencies brought within the organization.

Beginning in 2010, Peggy served as Financial Product Owner with a prominent Dallas based EMR, navigating through CMS regulated hospice claim changes that included Software enhancements, new features and repurposing existing functionality.

Peggy Is ACHC Certified, holds a BSBA and is a member of numerous state Home Health and Hospice associations.