CareKinesis Presents: PACE Audit Basics for the 1/3 Financial Audits
Wednesday, January 23, 2019, 3:00 – 4:00 PM EST
- Overview of audit timelines and requests – health plan survey, document requests, and PDE sample requests
- Common areas of risk – B vs. D, Part A stays (SNF and hospital), TrOOP-in/TrOOP-out, P2P and COB/MSP, and documentation shortfalls
- Areas of new or increased focus – opioid utilization oversight, over-prescribing or refill-too-soon, prescription linked to diagnosis code, and screening vendors, providers, and employees
- against the Preclusion List or OIG Exclusion List
Presenter: Deborah Quillen
Deborah Quillen has been working with PACE organizations at various levels for the past 13 years. She joined the CareKinesis team as Client Development Liaison in February 2016. Before joining the CareKinesis team, she worked with SeniorScript PBM as an account manager, and prior to that she worked as a Contracts Manager for a large PACE plan. Deborah has worked with all areas of the PACE plan and has gained hands-on experience with PACE operations, regulations, and the challenges faced by caregivers, as well as administrative staff members.
Deborah also has extensive experience in project management, process improvement, training, and change management. She has a BA in Management from St. Mary’s College in Moraga, CA.
Deborah has been a strong advocate for expanding PACE in order to reach the frail elderly people who so desperately need PACE services. She enjoys having the opportunity to support her PACE clients, making it easier for them to do the important work of providing medication and care to their participants.