HCM Marketplace

AUDIOCONFERENCE ON CD OR AUDIO ARCHIVE

Sponsored by Briefings on APCs

presented on February 14, 2008

Expanded packaging and the introduction of composite APCs will have a significant

financial impact on your hospital in 2008. Make sure you’re prepared.

For 2008, CMS made one of the largest and most sweeping changes to the OPPS in years. Many services and procedures— including observation and many imaging services— that were separately payable in 2007 will NOT generate separate APC payment in 2008.  Payment will depend on what other services are billed on the same claim.  Does your facility know the financial implications of this change?  Are your coders, billers, and financial staff prepared?

Go beyond learning the rules and delve into understanding the financial and operational impact these changes will have on your facility. During this 90-minute audioconference our expert speakers Jugna Shah, MPH and Valerie A. Rinkle, MPAcover everything from packaging, bundling, and composite APCs to what is separately billable versus separately payable. They also provide tips on how you can estimate the impact of Medicare’s expanded packaging on your facility’s reimbursement and help prepare your coding and billing staff to make sure they continue to capture all appropriate charges. Finally, you’ll walk away with an understanding of the future implications of this change, including possible single payment rates for full episodes of care.

Here’s what one expert has to say about the importance of accurate reporting

“What providers report in terms of charges really matters.  If providers report incorrect charges or omit reporting charges, then future APC payment rates are expected to decline.” —Jugna Shah, MPH

TAKE A LOOK AT OUR AGENDA

1. Understanding CMS’ expanded packaging for 2008
1. Why CMS made the change and the evolution of packaging under OPPS
2. Packaging definitions and bundling terminology
1. Conditional packaging
2. Unconditional packaging
3. Categories of packaged services and what codes are being packaged
1. Coding implications
2. Charging implications
2. Composite APCs
1. Definitions and terminology
2. A closer look at observation services
3. The financial impact
1. Reporting packaged services in the future and the implications of not reporting on future APC payment rates
2. Reviewing claim examples to illustrate the impact of CMS’ expanded packaging: Will packaging have a positive or a negative impact on revenue?
3. Other issues to watch for (e.g., the implication of Medicare’s packaging on other payers and providers, the implications due to ASCs going to APCs, etc.)
4. The future of Medicare packaging and OPPS
5. Q&A

Please note: Purchasers should have a basic working knowledge of APCs and how to calculate APC payment rates for outpatient cases as well as a general familiarity with the changes in the 2008 OPPS final rule.

LEARNING OBJECTIVES

By the end of the program you will be able to:

1. State clearly what services CMS will and will not pay separately
2. Indicate the importance to future payment rates of continuing to separately bill services whether or not they’re separately paid
3. Analyze how to assess and compute the financial impact related to packaging—both for the facility and a single department
4. Communicate the changes in packaging to appropriate finance, coding/billing, and chargemaster staff

YOUR MATERIALS PACKET

In addition to the expertise and advice presented during this audioconference, you'll also receive a slide presentation of the program materials and a related Briefings on APCs article.

These materials are provided with PDF links.

MEET THE SPEAKERS

Jugna Shah, MPH, is president of Nimitt Consulting in Washington, DC. She is a frequent audioconference speaker and a contributing writer to both HCPro's newsletter, Briefings on APCs, and the book, Compliance Troubleshooter. She has extensive experience helping providers understand and address the clinical and financial implications of APCs, facilitating APC task force meetings, strategic planning sessions, financial impact analyses discussions, and managing APC implementation and assessment projects.

Valerie A. Rinkle, MPA, is revenue integrity department director for Asante Health System in Medford, OR. She has over 20 years of healthcare reimbursement experience including 11 years in nationwide consulting to hospitals and physicians regarding Medicare and Medicaid payment systems and compliance. She is a the author of numerous articles on OPPS and hospital-based clinics, and a member of the editorial advisory board for the APC Answer Letter and the APC Weekly Monitor, both from HCPro.

EARN CONTINUING EDUCATION CREDITS

This program has prior approval of the American Academy of Professional Coders for 1.5 Continuing Education Units. Granting of this approval in no way constitutes endorsement by the Academy of the program, content or the program sponsor.

WHO SHOULD LISTEN

Finance managers and staff, revenue cycle managers and staff, compliance officers, chargemaster coordinators, patient accounts, payment validation specialists, cost report coordinators, revenue cycle managers, reimbursement managers, HIM directors and managers, coding managers and outpatient coding staff, APC coordinators, and clinical staff

Purchase a 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.

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