Course Code: REL-PAC-WB-SAHA
Hours: 1.5
Type: Online Course
Content Expiration Date: 12/31/2024
Learning Objectives:
Recall current CMS contractor audits.
Describe the aberrant data that frequently leads to a hospice’s selection for payment-related scrutiny.
Explain the correlation between PEPPER reports and payment-related scrutiny.
List three compliance-related steps to take today to mitigate future payment-related scrutiny.
Outline:
Objectives
CMS Contractor Audit Activity
What Is Driving Payment-Related Scrutiny in Hospice?
Data Analysis – PEPPER
PEPPER and Contractors
Payment-Related Scrutiny and PEPPER Correlation
PEPPER Target Areas
Response to Payment Related Scrutiny
Audit Response
Most Common Claim Denial Reasons
What to do NOW to Mitigate Risk
Up Your Regulatory Game!
Review and Improve Documentation Systems
Ensure a Robust and Real-Time QAPI and Compliance Program
Does Your Compliance Officer Act More Like
Act Now
Questions and Answers
References
Instructor: Carrie Cooley, RN, MSN
Carrie Cooley is the Principal of Weatherbee Resources. Carrie joined Weatherbee in 2009 as an Associate Consultant and was hired as the Consulting Coordinator in 2012. In 2014, Carrie was promoted to the Director of the Consulting Division and in July 2015, she assumed the Chief Operating Officer position. Carrie was promoted to CEO in February 2018.
In August 2021, Carrie became the sole owner of Weatherbee Resources having purchased the company with a business partner in 2018 from the company’s founders, Heather Wilson and Joy Barry. Carrie continues the long-standing history of Weatherbee Resources’ service to the hospice community.
In her role as Principal, Carrie ensures Weatherbee’s consulting services, products, and education are provided in a professional and cost-effective manner and are specifically tailored to meet each client’s individual needs. As one of Weatherbee’s owners, Carrie is responsible for ensuring Weatherbee is positioned to assist hospices with the ever-changing regulatory hospice environment.
Carrie’s regulatory expertise and extensive consulting experience includes forensic clinical record auditing, baseline compliance audits/mock surveys, interim management, clinical due diligence, and executive coaching. Carrie and her team also work directly with clients’ legal counsel in preparation for arbitration and other hearings; Carrie frequently serves as an expert witness. Weatherbee also works extensively with clients who are under a Corporate Integrity Agreement (CIA); Carrie and her team manage the Independent Review Organization (IRO) audit activities required by the Office of Inspector General (OIG). Carrie’s excellent rapport with executives and staff alike – coupled with her regulatory and clinical acumen, and knowledge of best practices – assures excellent consulting outcomes.
Under Carrie’s leadership, Weatherbee has assisted hundreds of clients under investigation by various Medicare contractors including: Targeted Probe and Educate (TPE), Zone Program Integrity Contractors (ZPIC), Unified Program Integrity Contractors (UPIC), Benefit Integrity Support Centers (BISC), Recovery Auditors (RA), the Department of Justice (DOJ), and the OIG.
As a member of Weatherbee’s Speaker’s Bureau, Carrie teaches a broad range of hospice, regulatory, and leadership-related topics nationally and is a member of the faculty for Weatherbee’s renowned Hospice Regulatory Boot Camps. Carrie also frequently speaks at state and national hospice conferences on compliance-related topics.
Carrie is a registered nurse and holds a master’s degree from Samford University with a specialty in nursing leadership and healthcare finance.
Target Audience:
The target audience for this course is: Nurses; in the following settings: Post-Acute Care.
Relias Learning will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
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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.