Observation Services 2012
Build an audit defense, obtain appropriate reimbursement
Product Description:
LIVE AUDIO CONFERENCE
Sponsored by: Observation Services: A Guide to Compliant Level of Care Determinations, Third Edition
Tuesday, July 10, 2012
New in 2012!
Buy the live audio and download the on demand version FREE!
You’ll be able to download the on demand version to share with staff who can’t listen to the live call. Use it as a training tool at your convenience—whenever staff need a refresher or new staff need to understand a new concept. Play it once or dozens of times! $259 value!
CERTs, RACs, MACs, and the OIG continue to audit hospitals with an emphasis on medical necessity of inpatient admission. Yet sometimes demand letters and auditor rationale for denial don’t make sense. You need to have an established audit defense team and an effective appeals process.
During this live two-hour audio conference, our expert speaker, Deborah K. Hale, CCS, CCDS, will help you build a strong defense against audit risk, review level of care regulations, address medical necessity requirements, and discuss main elements of an effective appeals process. You'll walk away with proven strategies to avoid overusing observation services and obtain appropriate payment for observation services ordered correctly.
This is a basic to intermediate level program.
LEARNING OBJECTIVES
- Recognize main elements of CMS guidelines for determining level of care
- Describe recent CERT, RAC, MAC, and OIG medical necessity audit findings
- Explain main elements of an effective utilization management process
- Bill accurately for appropriate observation reimbursement
- Describe the main elements of an effective appeals process for admission necessity
AGENDA
- Physician order requirements
- Observation and inpatient order wording, electronic order entry
- Backdating the order
- Inpatient-only surgery list
- Optimal observation hours, including carve outs
- Billable services provided during the observation periodical necessity audit initiatives
- OIG
- CERT
- RAC
- MAC
- Hospital compliance strategies
- UR committee, physician advisor roles
- Condition code 44
- Provider liable claims
- Best practices
- Virtual observation unit
- Dedicated observation unit
- A live question and answer session will follow the presentation.
MEET THE SPEAKER
Deborah K. Hale, CCS, CCDS, is president of Administrative Consultant Service, LLC, in Shawnee, OK, and has more than 30 years of experience in health care management including administration, health information management, clinical documentation improvement, resource outcome management and utilization review. She is the author of “Observation Status: A Complete Guide to Compliant Level of Care Determinations,” from HCPro.
BONUS MATERIAL
In addition to the expertise and advice presented during this audio conference, you'll also receive a slide presentation of the program materials plus the following bonus items:
These materials are provided with PDF links.
CONTINUING EDUCATION
AAPC
This program has prior approval of AAPC for 1.5 Continuing Education Units. Granting of this approval in no way constitutes endorsement by AAPC of the program, content or the program sponsor.
AHIMA
This program has been approved for 1.0 continuing education unit for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).
CCDS
This program has been approved for 1.5 continuing education units towards fulfilling the requirements of the Certified Clinical Documentation Specialist (CCDS) certification, offered as a service of the Association of Clinical Documentation Improvement Specialists (ACDIS).
Please note the expiration date for this audio is 7/10/13.
WHO SHOULD LISTEN?
Case management directors, case managers, UR nurses, revenue cycle managers, physicians, compliance officers, patient access staff, clinical documentation improvement specialists.
DIAL IN TOLL-FREE!
You can now call in toll-free to our live audio conferences. This added benefit means you can save on long-distance charges and receive even more value from this important program! Details on how to call will be sent to you via e-mail with your materials package.
CAN'T LISTEN LIVE?
No problem. Purchase a CD or an audio on-demand of the audio conference and listen when you can. It's also a perfect training tool for new staff or as a refresher for veteran staff.
PLEASE NOTE
- Participation in the call is just $259 per site and allows access to ONE phone line for an unlimited number of people to listen. All materials must be retrieved from the Internet. Live orders are assessed a $5 processing fee. CD, and combo orders are charged $18 for shipping and handling.
- Audio conference materials will be delivered via e-mail four days prior to the conference and again the day before the conference.
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