Observation Status (Audio Conference)

AUDIO CONFERENCE ON CD OR AUDIO ON-DEMAND

Sponsored by Medicare Boot Camp-Hospital version

presented on December 12, 2008

Observation status can be a dreaded phrase because of the potential headaches associated with proper documentation of a patient's experience at your hospital. Communication between doctors, case managers, registration staff, and billing and coding departments is crucial. New guidelines on calculating time for observation, as well as difficult-to-understand coverage guidelines, make observation a perfect target for the new permanent RACs. Reimbursement dollars are at stake, and your facility must do everything it can to ensure it complies with Medicare requirements.

Effectively manage an observation status program

Listen to HCPro for the 120-minute audio conference Observation Status: Document Appropriate Patient Status and Ensure Accurate Billing. Experts Kimberly Anderwood Hoy, JD, CPC (HCPro) and Wendy De Vreugd, RN, BSN, PHN, FNP (Kindred Healthcare) provide analysis of the current regulatory environment related to observation status and help you determine the appropriate patient classification. Through a detailed case study you will see first-hand how a real-world healthcare system improved its ability to determine observation status and saw its reimbursements rise and its denials decrease as a result.

AT THE END OF THIS AUDIO CONFERENCE YOU WILL BE ABLE TO:

• Identify situations where Medicare does not cover services described by the hospital as "observation."
• Determine the number of hours of observation to be billed to Medicare based on coverage requirements for Medicare.
• Define situations when billing non-covered hours of observation to Medicare leads to overpayments and repayment obligations.
• Identify the proper use of Condition Code 44 and how to bill when you do not meet requirements for Condition Code 44.
• Identify how Medicare pays for observation services as part of Extended Assessment and Management Composite APCs.
• Develop an understanding of observation program management.

AGENDA

• Observation status coverage rules
• Observation billing and how it is affected by clinical documentation
• Physician documentation requirements
• Documentation of time
• Payment for observation services
• Inpatient payment under the 3-day rule
• Extended assessment and management composite payments for outpatients
• Handling incorrect patient status
• Billing with Condition Code 44
• Billing without Condition Code 44
• Challenges in documenting and billing correct patient status
• Appropriateness criteria
• Developing a concurrent utilization monitoring system to address major diagnoses
• Case Study
• Correct billing
• Accurate payment
• Question and answer session

MEET THE SPEAKERS

Kimberly Anderwood Hoy, JD, CPC. Ms. Hoy is the director of Medicare and compliance for HCPro, Inc. Prior to joining HCPro, she was the lead instructor for HRAI's Medicare Boot Camp® - Hospital Version. Hoy has served as a compliance officer and in-house legal counsel for hospitals and has developed and implemented corporate-wide compliance programs for two hospitals. She also speaks at national conferences on observation services.

Wendy De Vreugd, RN, BSN, PHN, FNP. Ms. De Vreugd is the senior director of case management for the West and Mid-West hospital division of Kindred Healthcare, a long-term acute care hospital system. She has 39 years of clinical nursing experience in the healthcare industry and short-term acute care hospitals, including 28 years in case management.

WHO SHOULD LISTEN?

• Case managers
• Chief executive officers
• Chief financial officers
• Chief medical officers
• Chief compliance officers
• Managed care directors
• Directors of case management
• Vice president/directors of revenue cycle
• Directors of patient financial services
• Directors of regulatory affairs
• Directors of risk management
• Hospital legal/regulatory counsel
• Hospital financial managers

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.

• Audio Conferences

• Other Finance Products
• Other Revenue Cycle Products