EVENTS
Home Health – Basics of Claims Processing 2026
Speaker(s): Melinda A. Gaboury, CEO
Category: Home Care
Speaker(s): Melinda A. Gaboury, CEO
About the Speaker(s)
Melinda A. Gaboury, with more than 30 years in home care, has over 22 years of executive speaking and educating experience, including extensive day to day interaction with home care and hospice professionals. She routinely conducts Home Care and Hospice Reimbursement Workshops and speaks at state association meetings throughout the country. Melinda has profound experience in Medicare PDGM training, billing, collections, case-mix calculations, chart reviews and due diligence. UPIC, RA, ADR & TPE appeals with all Medicare MACs have become the forefront of Melinda’s current impact on the industry. She is currently serving as the Chair of the NAHC/HHFMA Advisory Board and Work Group and is currently serving on the Board of Directors for both the Home Care Association of Florida & Tennessee Association for Home Care. Melinda is also the author of the Home Health OASIS Guide to OASIS-E and Home Health Billing Answers, 2023.
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About the Event
Home Health – Basics of Claims Processing 2026
Speaker: Melinda A. Gaboury, COS-C
May 7, 2026
New and experienced home health billers should periodically review eligibility requirements and recent reimbursement clarifications. January 2026 brought big changes based on the 2026 Home Health Final Rule including rate changes for home health, multiple PDGM adjustments and the Value-Based Purchasing Model changes. The focus of this session will be the details of the Notice of Admission and the filing of Final Claims. Getting reimbursed timely and correctly is of major importance and will require tightly managing the 30-day payment periods. Are you leaving money on the table?
1:00 – 2:30 Session 1 – Details of Current Payment Rates & Notice of Admission
- Evaluate the specificity requirements of PDGM
- Detail the content of the Notice of Admission (NOA)
- Outline the exceptions request for a Late NOA
2:30 – 3:00 Break
3:00 – 4:30 Session 2 – Details of Final Claims & Troubleshooting
- Detail the requirements for submitting Final claims
- Review the complexity of determining LUPA thresholds under PDGM
- Establish the basis for identifying HHVBP adjustments on the claim
- Review the reconciliation process after posting payments for claims