Critical Access Hospital Coding and Billing
The Truth Behind Common Myths
Product Description:
This program is intended for critical access hospital employees
Audio Conference on CD or Audio On-Demand
Sponsored by Briefings on Coding Compliance Strategies
presented on March 9, 2009
Do you know whether critical access hospitals (CAH) have the same observation billing requirements as acute care hospitals? Do you know whether the three-day payment window, MS-DRGs, or present on admission (POA) indicators apply to CAHs? Are you aware of the fact that CAHs are also vulnerable to the recovery audit contractor (RAC) program?
Despite many differences, CAHs and acute care hospitals have a significant amount in common. HIM professionals at CAHs must be aware that certain acute care regulations, transmittals, and guidelines do, in fact, apply to their hospital.
You're not as different as you think!
The boundaries between a CAH and an acute care facility can be blurry at times, and CAH billers and coders risk lost revenue if they don't understand which policies affect their hospital. Listen to HCPro's 90-minute audio conference Critical Access Hospital Coding and Billing: The Truth Behind Common Myths. Speakers Debbie Mackaman, RHIA, CHCO, (Marcus Daly Hospital) and Linda Coe (QHR), address common misconceptions about outpatient billing, RAC investigations, and more, and they illustrate the compliance ramifications for CAHs. The speakers provide relevant examples from their own first-hand experiences to help ensure compliance.
LEARNING OBJECTIVES
At the conclusion of this audio conference, you will be able to:
- Explain how cost-based payment methodology differs from the prospective payment system
- Describe coding and billing for various outpatient services and whether this differs on the acute care side
- Discuss the applicability of modifiers in a CAH setting
- Explain the relevance of RACs for CAHs
TAKE A LOOK AT THE AGENDA:
- Myth #1: Coding rules and DRG assignment
- Soft versus hard coding
- Assigning discharge disposition codes
- DRGs and the present on admission indicator
- Myth #2: Payment methodology
- Cost-based vs. prospective payment system
- Three-day payment window
- Myth #3: Outpatient services
- Coding for emergency room visits, pharmacy, radiology, infusion therapy, and lab
- Observation
- Myth #4: Medical necessity
- Applicability of modifiers
- NCCI Correct Coding Initiatives (NCCI) Edits
- Use of Advance Beneficiary Notices (ABNs)
- Myth #5: Recovery audit contractors
- RAC audits and findings
- The CAH focus
- A question and answer session follows the presentation
CONTINUING EDUCATION
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. Credits expire on February 28, 2010.
This program has been approved for 1 continuing education unit for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). The credit expires on March 9, 2010.
MEET THE SPEAKERS
Debbie Mackaman, RHIA, CHCO, compliance officer/director of health information, Marcus Daly Hospital, (Hamilton, MT). Ms. Mackaman has more than 16 years of experience in the healthcare industry, including both PPS and CAH coding and reimbursement systems. She addresses a wide range of coding and billing issues for hospitals, physicians, and home health. She also develops and manages compliance programs with a focus on high-risk areas, auditing, and charge master maintenance. Ms. Mackaman is an adjunct instructor for the HCPro Medicare Boot Camp® - Hospital Version.
Linda Coe, RN, CCS, senior consultant, CDM & Coding, QHR (Brentwood, TN). Coe has more than 20 years experience in coding and reimbursement, assisting health care organizations with improving and monitoring the quality of coding and documentation to secure appropriate reimbursement. She has performed, DRG/APC validation, coding accuracy audits, and Comprehensive Chargemaster Reviews, as well as conducting workshops for coders, physicians, nurses, and other clinicians.
WHO SHOULD LISTEN?
Professionals in a CAH, including:
- Coders
- Billers
- HIM directors
- Compliance officers
- Finance, business managers
- Clinical managers
- CEO, CFO, COO
- Auditors
AUDIO ON-DEMAND
In addition to the regular purchase options for HCPro audio conferences, we are pleased to offer another option, 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.
Product Types : Departments :
