AUDIO CONFERENCE ON CD OR AUDIO ON-DEMAND
Sponsored by The Healthcare Audit Resource Center
presented on October 28, 2008
Why should you worry about compliance efforts related to observation status? Recent Recovery Audit Contractor (RACs) investigations found millions in inappropriate Medicare reimbursements—much of it from inappropriately billed observation status.
In 2005, Cleveland Clinic Florida Hospital paid $2.75 million to resolve allegations that it inappropriately billed Medicare for observation services. In particular, the settlement agreement resolved allegations that Cleveland Clinic frequently billed Medicare for extra observation charges during normal recovery periods following minor surgery or emergency room visits.
Tips for observation compliance
Listen to HCPro's 90-minute audio conference Observation Status: Tools to Audit Your Facility and Reduce Compliance Risks. Healthcare compliance attorney Robert Wade, Esq. (Partner, Baker & Daniels, LLP) and healthcare compliance consultant Brenda Lingle (Baker & Daniels, LLP) navigate through the complexities of billing for observation status. The speakers will outline procedures to implement a thorough audit plan, so your facility can comply with the latest OIG regulations, prepare for RAC scrutiny of observation services, and recover reimbursement from all services rendered to patients under observation.
This audio conference includes tips compliance professionals can use to partner with physicians to ensure proper documentation.
At the end of this audio conference, you will be able to
- Audit compliance with observation status rules
- Properly charge for observation services according to Medicare guidelines
- Identify services that are not covered as observation
- State what composite APCs are and how they effect reimbursement
- Implement a process to reduce the risk of inappropriate observation billing
AGENDA
- Auditing Functions and Compliance
- False Claims Act
- Corporate Integrity Agreements
- The importance of auditing and monitoring as part of an effective compliance program
- What's on the horizon
- RACS
- Increased Medicaid Fraud Prevention Activity
- ZPICs
- Observation According to Medicare
- Examples of conditions that may support observation
- Services not qualified for observation
- Physician Involvement
- Calculating Observation Hours
- Condition Code 44
- Billing Observation Services to Medicare
- Composite APCs
- Charge Capture
- 3-Day rule
- Why and How to Audit
- Periodic Reviews
- Q&A
BONUS TOOLS
In addition to the expertise and advice presented during this audio conference, you'll also receive a slide presentation of the program materials and:
- Chart audit worksheet
- Sample observation audit plan
These materials are provided with PDF links.
MEET THE SPEAKERS
Robert A. Wade, Esq., Partner, Baker and Daniels, LLP. Mr. Wade concentrates his practice in representing a variety of healthcare clients. His specialization includes representing clients with respect to the Stark Law, Anti-Kickback Statute, False Claims Act, and Emergency Medical Treatment and Labor Act. Mr. Wade is a nationally-recognized expert in all aspects of healthcare compliance and he has experience in representing clients with respect to issues being investigated by the Department of Justice and the Office of Inspector General.
Brenda Lingle, Baker and Daniels, LLP. Ms. Lingle is a compliance consultant in the health and life sciences practice group. She provides documentation and coding compliance assistance for physician practices and hospital outpatient departments. Ms. Lingle has extensive experience in physician/provider evaluation and management (E/M) documentation review and education in a variety of specialties. She also has experience in documentation review for several outpatient hospital services.
WHO SHOULD LISTEN?
Professionals from large hospitals who have the following titles or work in the following departments:
- Compliance professionals
- Auditors
- Director of finance
- Revenue Cycle
- Case Management
- Utilization Review
- Health Information Management
PROGRAM MATERIALS:
Program materials are provided with PDF links.
AUDIO ON-DEMAND
In addition to the regular purchase options for HCPro audio conferences, 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. 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.
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.
