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    7 Courses

Annette Lee

RN, MS, HCS-D, COS-C

Annette is a registered nurse who has been practicing since 1990, with the majority of her nursing experience being in public health care. She has a master's degree in health care administration. In 2000 she joined the home health intermediary Cahaba GBA, where she became an instructor, providing education to home health and hospice providers on Medicare reimbursement issues and effective documentation strategies nationally. After nearly a decade working for the intermediary, she began Provider Insights, Inc. In the private sector, she was able to provide insights into Medicare regulations and how to make them work for agencies on a day-to-day basis to both increase quality and reduce risk. CGS also contracted Provider Insights, Inc. to perform all of the MAC's clinical education for home health and hospice providers. Her broad experiences make her uniquely able to provide practical solutions to meet the requirements of the fiscal intermediary system and medical review within the real-world environment of hospice and home health. She presents nationally on hospice, LCDs, home health coverage, OASIS, PPS, medical review/appeals, documentation, and coverage.

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Hospice: Conditions for Payment

Presented by Annette Lee, RN, MS, HCS-D, COS-C

Hospice: Conditions for Payment

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Video Runtime: 42 Minutes; Learning Assessment Time: 24 Minutes

Hospice clinicians must understand what the Medicare hospice benefit entails, as well as the conditions for this benefit. This session will clearly define all of the technical necessities and clinical indications for the hospice benefit and equip learners with the actual CMS citations so they can be the tiebreakers at their agencies, using CMS rules for decision-making and documentation.

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Medicare’s Keys to Documenting a Six-Month Prognosis: LCDs

Presented by Annette Lee, RN, MS, HCS-D, COS-C

Medicare’s Keys to Documenting a Six-Month Prognosis: LCDs

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
Video Runtime: 53 Minutes; Learning Assessment Time: 33 Minutes

No one has a crystal ball, so how do we know when patients are ready for hospice? There are specific tools each Medicare Administrative Contractor has gathered that have been shown to be useful in prognostication. These tools assist all hospice team members in understanding prognosis and provide both a foundation for key decision-making moments and an outline for our documentation.

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Hospice Medical Review From a Medical Reviewer's Perspective

Presented by Annette Lee, RN, MS, HCS-D, COS-C

Hospice Medical Review From a Medical Reviewer's Perspective

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
Video Runtime: 46 Minutes; Learning Assessment Time: 29 Minutes

Hospice leadership and clinicians should have a thorough understanding of the Medicare medical review process to ensure compliant documentation. This course provides information that will encourage clinicians to document more completely and accurately and will help internal reviewers and leadership understand how to review and prepare records when they are requested by payers. This course is appropriate for nurses and administrators who provide hospice services.

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Hospice Diagnosis Coding

Presented by Annette Lee, RN, MS, HCS-D, COS-C

Hospice Diagnosis Coding

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
Video Runtime: 22 Minutes; Learning Assessment Time: 16 Minutes

CMS clarified that hospices must report all diagnoses identified on hospice claims, whether or not they are related to a patient's terminal prognosis. For that reason, hospice clinicians must have a thorough understanding of what must be considered in ICD-10 coding for hospice patients. This course will define components that must be considered in ICD-10 coding for hospice patients and is appropriate for hospice nurses, coders, and administrators.

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How-To for Hospice Assessments: PPS, FAST, PAINAD, and More

Presented by Annette Lee, RN, MS, HCS-D, COS-C

How-To for Hospice Assessments: PPS, FAST, PAINAD, and More

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
Video Runtime: 45 Minutes; Learning Assessment Time: 31 Minutes

Functional assessment tools are valuable for decision-making at intake, at recertification, and throughout the course of care. This course examines these tools and provides direction on what to watch for and what to document. This course is appropriate for hospice nurses, social workers, and administrators.

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ABN, HHCCN, and NOMNC: When and Which to Give!

Presented by Annette Lee, RN, MS, HCS-D, COS-C

ABN, HHCCN, and NOMNC: When and Which to Give!

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
Video Runtime: 57 Minutes; Learning Assessment Runtime: 34 Minutes

CMS has reiterated in the 2018 COPs the need to provide patients with written notices when there is a change in their service, or if Medicare won't pay for services. This course will provide the foundational understanding necessary, as well as step-by-step instructions on how to fill out the CMS mandated forms for discharge, reduction of care, or providing care that Medicare will not pay for. These three types of notices can be cumbersome and are many times found to be mixed up by clinicians. "Real life" tips and tools will be provided to ensure you never have these mix-ups again!

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Observation and Assessment: When Will Medicare Pay?

Presented by Annette Lee, RN, MS, HCS-D, COS-C

Observation and Assessment: When Will Medicare Pay?

Subscribe now, and access clinical education and patient education—anytime, anywhere—with video instruction from recognized industry experts.
Video Runtime: 56 Minutes; Learning Assessment Runtime: 28 Minutes

Did you know that Medicare's most prevalent skill paid for in home health is observation and assessment? CMS has provided a manual to describe what services are paid for and under what circumstances. This manual, the Medicare Benefit Policy Manual, has a chapter for home health: Chapter 7, which describes the circumstances under which CMS would pay for nursing to provide observation and assessment. This course will discuss how this skilled service can be provided in "real life" circumstances, yielding positive outcomes for patients and ensuring payment will be secured.

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