AUDIOCONFERENCE ON TAPE, CD OR AUDIO ARCHIVE
Sponsored by Medicare Boot Camp – Hospital Version
presented on June 13, 2007
Avoid losing out on money your hospital is legally entitled to.
Unless you completely understand Medicare’s “three-day payment window rule” (also known as the “72-hour rule”), you may not be aware of your hospital’s ability to get reimbursed for services performed on the day of a patient’s admission. Many hospitals let these opportunities slip through the cracks and miss out on revenue to which they have a legitimate claim.
How can you remain in compliance with the rule as well as increase revenue opportunities?
Listen to this 90-minute audioconference. Two healthcare compliance experts will discuss the specifics of the three-day payment window rule, as well as clarifications of the rule recently issued by CMS. In addition, they will detail how to avoid compliance traps and how to take advantage of the revenue opportunities available under the rule.
Some of the major concepts to be defined and discussed are:
- When does the “three-day window” begin and when does it close?
- What services are considered “diagnostic” and “non-diagnostic”?
- When is an outpatient service “related” to an inpatient admission and therefore subject to the rule?
- Under what circumstance will an entity be considered “wholly owned” or “wholly operated” and therefore subject to the rule?
Capture the revenue you deserve by using the “three-day payment window rule” to your advantage. Our experts show you how to incorporate the tenets of the rule into your billing process, as well as detail any coding or systems issues. They also provide real-world examples of how reimbursement opportunities can be found in unexpected places, as well as how an allegation of non-compliance by a community hospital was successfully defended.
AGENDA
- Mechanics and recent CMS clarifications
- Operationalizing the rule
- Enforcement case study: How one hospital successfully defended itself against allegations of noncompliance
- Compliance traps and revenue opportunities
- Question & Answer Session
BONUS MATERIALS
Purchasers of this audioconference will also receive an example of a compliance tool used to compare pre-admission codes and principal inpatient diagnosis codes.
AT THE END OF THIS AUDIOCONFERENCE YOU WILL BE ABLE TO:
- Demonstrate awareness of current DOJ/OIG enforcement activity relating to the rule
- Understand recent CMS “clarifications” of the rule
- Determine when the rule applies and does not apply to services furnished by an affiliated entity
- Learn how revenue code assignment and ICD-9-CM coding affects compliance and payment under the rule
- Understand why the so-called “three-day window” is really a four-day rule
- Discover why many hospitals may be getting under reimbursed for Emergency Department services furnished on the day of an inpatient admission
- Operationalize the rule to ensure compliance and appropriate payment
MEET THE SPEAKERS
Hugh E. Aaron, MHA, JD, CPC, CPC-H. Mr. Aaron is HCPro's senior vice president for compliance and regulatory affairs/regulatory counsel with HCPro, Inc. Mr. Aaron's work focuses primarily on coding and billing accuracy with a particular emphasis on Medicare billing compliance. Prior to joining HCPro, Mr. Aaron practiced health law for approximately 13 years. He was also the founder and president of HRAI Coding Specialists, LLC, a national coding and billing training firm where he developed the Certified Coder Boot Camp®-Original Version, the Medicare Boot Camp®-Hospital Version, and the Medicare Boot Camp®-Professional Services Version courses, all now offered by HCPro. Mr. Aaron is an Adjunct Assistant Professor of Law at the University of Richmond School of Law and an Affiliate Assistant Professor in the Department of Health Administration at Virginia Commonwealth University (Medical College of Virginia Campus). He holds a Juris Doctor degree (cum laude) from the University of Richmond and a Master of Health Administration degree from the Medical College of Virginia.
Robert Rogalski, JD, Vice President & General Counsel, MedCenter One Health System, Bismarck, N.D. Mr. Rogalski has counseled health systems and hospitals for 15 years. He has worked as in-house counsel for the West Penn Allegheny Health System, the University of Pittsburgh Medical Center, and in private practice. Mr. Rogalski is a member of the American Health Lawyers Association, the Health Care Compliance Association, and the North Dakota and Pennsylvania bar associations. Mr. Rogalski holds a Juris Doctorate degree from the University of Pittsburgh.
WHO SHOULD LISTEN?
Reimbursement and finance professionals, compliance officers, HIM (coding and billing), revenue cycle, business office / patient accounts, legal counsel, leadership, as well as all corporate management (CEO, COO, CFO, CIO, etc.)
NEW PURCHASE OPTION: Audio Archive
In addition to the regular participation options for HCPro audioconferences - audio tape or audio CD, we are pleased to offer a new option, an audio archive. An audio archive allows you to download the program and play it back at your convenience on your computer or MP3 player. Purchase a tape, CD, or audio archive of the program and listen when you can. It's also a perfect training tool for new staff or as a refresher for veteran staff.
Save money when you purchase multiple copies! Ask your customer service representative about money-saving
discounts and bulk orders. Call toll free 800-650-6787 or e-mail
customerservice@hcpro.com.
