Medicare Qualifying Criteria & Recertification Requirements: Part 2

Presented by Georgia Hockenjos

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Video Runtime: 41 Minutes; Learning Assessment Time: 33 Minutes

The key to an organization’s ability to provide appropriate patient care, ensure regulatory compliance, and achieve financial success is understanding and operationalizing the Medicare home care qualifying criteria. This course is designed to provide a detailed review of the major Medicare qualifying criteria, using the Medicare Benefit Policy Manual as its reference. Examples and best practice processes will be provided to assist the participants in operationalizing their knowledge. Interactive review, including questions and answers, will be used as a summary to highlight areas of the course. This is Part 2 in a two-part series for Medicare Qualifying Criteria & Recertification Requirements

Meet your instructor

Georgia Hockenjos

Georgia Hockenjos, BSN, RN, is vice president and COO of Aleckna and Associates, Manalapan, New Jersey. Ms. Hockenjos has more than 40 years' experience in the home care industry, with more than 15 years in a management or director-level position at a large multibranch nonprofit home care agency (VNA) and 20 years as vice…

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Chapters & learning objectives

Reasonable and Medically Necessary and Skilled Intermittent Care

1. Reasonable and Medically Necessary and Skilled Intermittent Care

In order to qualify for Medicare home care, the care required must be skilled, intermittent, reasonable, and necessary. Understanding the definition of skilled, intermittent care and medically necessary can be difficult and imparting that knowledge to all clinicians often very challenging. This chapter will review the definitions of skilled intermittent care for skilled nursing, physical therapy, occupational therapy, and speech therapy and discuss reasonable and necessary requirements of care. Examples will be given throughout the chapter.

Pulling It All Together

2. Pulling It All Together

This chapter is designed to summarize and reinforce the information presented in the course. The methodology will be an interactive discussion between a home care supervisor and a nurse who is new to home care. The interactive discussion will highlight some of the key points presented in the chapters.