Reinhart: Expands hospice toolkit series to include guide for medical review and appeals

MADISON – Hospices often face a great deal of regulatory scrutiny with the potential for high legal costs. Over the last 15 years, Reinhart Boerner Van Deuren s.c. (Reinhart) has developed a series of toolkits to help hospices handle typical legal issues while keeping legal costs under control.

The popular toolkits are designed to give hospices the essential information and the assurance they need to succeed on their own. Reinhart’s newest toolkit, Medicare Hospice Appeals Toolkit: From the ADR to the ALJ, is the fourth in the series written by members of the firm’s nationally-focused Hospice and Palliative Care Legal Service Group. The Medicare Hospice Appeals Toolkit: From the ADR to the ALJ guides hospices looking for a comprehensive overview of the Medicare medical review and claim appeals process, and contains materials designed to manage the additional development request (ADR) process.

Meg S.L. Pekarske, co-chair of Reinhart’s Hospice and Palliative Care Legal Services Group, notes that “with each chapter, hospices learn the practical and strategic considerations associated with the ADR, targeted medical review and each level of the appeals process, with particular attention to the administrative law judge (ALJ) hearing.”

The toolkit is further summed up as “an awesome reference manual” by Sue Wilford, Quality Services Coordinator at Ministry Home Care. She stresses that the toolkit helps hospices to be well-informed and confident when challenging wrongly denied claims.

Renee Hahn, Chief Financial Officer of Harry Hynes Memorial Hospice, comments that “this toolkit is an easy-to-read, yet invaluable, comprehensive guide to understanding the Medicare appeals process. It simplifies the overwhelming tasks in managing and responding to the different levels of appeals!”

Using this thorough guide, hospices can learn how to:

• Effectively respond to record requests from the Intermediary/Medicare Administrative Contractor (MAC) or Recovery Audit Contractors (RAC)

• Understand the types of probes hospices face and their consequences

• Navigate the appeals process when a claim is denied

Betty Oldanie, VP of Planning for Suncoast Hospice exclaims Reinhart has once again “created a valuable resource for hospices nationwide… [that] provides a roadmap for hospices trying to understand and manage the ADR process. It provides an overview…as well as in depth information and tools to guide hospices with each step of the way. It is organized in a logical, sequential fashion and helps the reader by answering many pressing questions, as they arise.“

In addition, this toolkit provides:

• Sample cover letters illustrating different options for presenting a case at the ADR, redetermination, reconsideration and ALJ levels

• Fully customizable template letters for each level of response and detailed instructions on how to prepare an effective letter

• A sample ADR and appeals spreadsheet for tracking deadlines and key information about claim denials

• Sample checklists and a “to-do” list that outlines the tasks and decisions that need to be completed at each level of appeal

To allow for easy customization, the templates and checklists are provided on an accompanying CD-ROM.

About Reinhart’s Toolkit Series

The Medicare Appeals Toolkit: >From the ADR to the ALJ is available for purchase at the list price of $1095. Reinhart’s clients can purchase this toolkit at the reduced price of $650 by calling 608-229-2260 or by using the order form available on Reinhart’s Web site. The price for National Hospice and Palliative Care Organization (NHPCO) members who order through the NHPCO Marketplace is $695 plus shipping and handling.

Hospices interested in exploring other toolkits developed by Reinhart to cost-effectively customize their approach to important areas of care and contracting have the following resources available for purchase:

• Hospice & Nursing Home/Assisted Living Contracting Toolkit

• Medical Director & Physician Contracting Toolkit for Hospice & Palliative Care

• Hospice Vendor Contracting Toolkit

About Reinhart Boerner Van Deuren s.c.

Reinhart Boerner Van Deuren s.c. is a full-service, business-oriented law firm with offices in Milwaukee, Waukesha and Madison, Wisconsin and Rockford, Illinois. The firm’s more than 200 attorneys serve clients throughout the U.S. and internationally with a combination of legal advice, industry understanding and superior client service.

For more information about Reinhart’s Hospice and Palliative Care Legal Service Group, the toolkits or to subscribe to complimentary Headlines in Hospice and Palliative Care E-Alerts, please visit http://www.reinhartlaw.com.

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REINHART MEDIA CONTACTS:

Kirk Kusick

Marketing Manager

Phone: (414) 298-8437

kkusick@reinhartlaw.com

Robyn Radomski

Chief Marketing Officer

Phone: (414) 298-8744

rradomski@reinhartlaw.com