LIVE AUDIOCONFERENCE
Sponsored by The Healthcare Compliance Professional's Guide to Risk Assessments
Friday, May 30, 2008
1:00-2:30 p.m. (Eastern)
12:00-1:30 p.m. (Central)
11:00-12:30 p.m. (Mountain)
10:00-11:30 a.m. (Pacific)
You have to protect yourself—and your organization—from the risks associated with the newest coding and billing rules. Join HCPro for the live 90-minute audioconference Hospital Outpatient Billing: Understanding and Addressing Hidden Compliance Risks, to update your outpatient compliance checklist and reduce your risk.
At the conclusion of this audioconference, you will be able to:
- Identify and assess your compliance vulnerabilities beyond the OIG Work Plan
- Describe the latest "hidden" outpatient billing and compliance risks that RACs, MACs, and FIs could use to audit your facility
- Identify risk areas associated with CERT denials and requests with more diligence
- Determine how to use CMS' open door forum to ask questions
- Perform due diligence on your internal practices
- Develop policies and procedures – your arsenal in case your facility comes under investigation
- Foster a relationship with your state hospital association to alert them to concerns that hospitals consider significant and need more formal guidance
- Seek clarification and formal guidance from CMS and your MAC/FI
The landscape for hospital outpatient billing is shifting—you need to keep up with the changes.
With the arrival of recovery audit contractors (RACs), the expansion of the comprehensive error rate testing (CERT) program, and new rules associated with the Deficit Reduction Act (DRA), the compliance and financial risks associated with hospital outpatient billing go far beyond the items listed in the OIG's annual Work Plan.
In the past 18 months, CMS began issuing new "guidance" often in the form of verbal information in Open Door Forum calls or through the release of frequently asked questions on the CMS Web site. The threat of investigations, inspections, and fines for things that providers may be completely unaware of are enough to give even the best compliance officers something to worry about.
Speakers, Jugna Shah, MPH, and Valerie Rinkle, MPA, bring considerable experience in OPPS/APC hospital outpatient facility billing and compliance to this event. They will discuss the risk areas and trends surrounding hospital outpatient billing—and give you strategies for how to manage these risks.
Note: Audience members should have a basic understanding of hospital compliance and of the outpatient prospective payment system, as well as general familiarity with recent OIG Work Plans.
TAKE A LOOK AT THE AGENDA
- Understanding what's in the latest OIG work plan with respect to hospital outpatient/facility coding/billing compliance concerns
- Moving beyond the OIG work plan to understand "hidden" compliance risks due to recent policy/regulatory changes
- Recent updates from CMS on reporting critical care
- Guidance changes related to reporting separately identifiable/medically necessary services
- Impact of Medically Unlikely Edits (MUEs)
- Modifier analysis: -25, -52, -59, -73, -74
- Drug administration – injection and infusion services
- Charging inpatients and outpatients the same
- And more...
- The big picture: What the future holds
- Implication of RAC analysis on outpatient billing
- Impact of the new Medicare Contract Reform and Medicare Administrative Contractors (MAC)
- Implications of CERT
- Packaging—separately billable vs. packaged observation services
- Strategies for what providers need to do from asking questions to shoring up their internal practices based on many of the recent changes being issued by CMS
- A live question and answer sessions follows the presentation
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 the HCPro 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 cycle director for Asante Health System in Medford, OR. She has more than 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.
WHO SHOULD LISTEN?
Compliance officers, healthcare administrators, and finance directors.
BONUS MATERIAL INCLUDED IN YOUR MATERIAL PACKET!
In addition to the expertise and advice presented during this audioconference, you'll also receive a slide presentation of the program materials. These materials will be provided prior to the program date via e-mail with PDF links. Please download the PDF files before the start of the program.
PROGRAM MATERIALS
Program materials will be provided with PDF links via e-mail four days prior to the conference and again on the day before the conference. Please download the PDF files before the day of the program.
DIAL IN TOLL-FREE!
You can call in toll-free to our live audioconferences. 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.
AUDIO ON-DEMAND
In addition to the regular participation options for HCPro audioconferences—live, CD, or combination packages—we are pleased to offer another option, an audio on-demand. Audio on-demand allows you to download the program and play it back at your convenience through your computer or MP3 player.
CAN'T LISTEN LIVE?
No problem. Purchase a CD or audio on-demand 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. CD and audio-on-demand orders will be fulfilled after the date of the live program.
PLEASE NOTE
Participation in the call is just $279 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.
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.
