10/26/2009: Medicare Compliance Forum: Observation Status Track
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Product Description:
On-demand audio recordings of the Observation Services track
of HCPro Revenue Cycle Institute's popular Medicare Compliance Forum
held October 26-27, 2009, in Atlanta
This event featured nationally recognized regulatory experts and in-the-trenches healthcare providers addressing key Medicare compliance concerns with practical and innovative approaches for compliance success.
Failing to properly classify a patient as observation services or inpatient affects both the clinical and financial success of your hospital. The Observation Services track is designed to help you master one-day stays and observation services. Each session is described below.
Purchase all six sessions for $399 or individual presentations for $79 each. All of the sessions are sold as MP3 downloads. Each session is 60 to 90 minutes in length. Click the appropriate link to add presentations or the entire six-session package your shopping cart.
For information on Medicare Compliance Forum tracks for Recovery Audit Contractors and Physician Advisors, click the appropriate link.
Individual sessions
Medicare Coverage Conditions and Definitions
This session will review key elements of the Medicare Benefit Policy Manual instructions for appropriate admission to inpatient and observation services, as well as CMS’ new clarifications on observation, inpatient and observation decision-making, and outpatient surgery and the effect of the inpatient-only list.
Speaker: Deborah Hale, CCS
UR Committee and Optimizing Condition Code 44
This session covers compliance strategies for preventing and correcting level-of-care errors. Learn how to implement an effective response to the one-day-stay initiative, evaluate the accuracy of the existing corrective action plan, the proper use of condition code 44 and utilization review committee responsibilities, manage provider-liable claims, and the pros and cons of the case management protocol.
Speaker: Deborah Hale, CCS
A Practical Approach to Medicare Compliance, Medical Necessity and Revenue Integrity
Learn why observation services and one-day stays have become major compliance problems that cause significant lost revenue from inappropriate observation claims and exposure to potential false claims action. This session also covers the effect of CMS’ mandate to uncover overpayments due to lack of medical necessity, why QIOs initiated one-day-stay programs, the difficulties of patient status, a review of the rules for RACs, the RAC audit process, and RAC payment appeals levels.
Speaker: Joe Zebrowitz, MD
Billing and Payment for Observation Services Under Medicare
This session addresses common billing challenges for Medicare patients, including drugs and minor procedures. Topics include how Medicare pays for observation services, including the new Medicare Composite APCs, how to bill for packaged services related to observation services (e.g., self-administered drugs, drug administration, minor procedures), ways to manage documentation requirements for payment, strategies for mastering billing that applies to condition code 44, and how to bill and get paid for services even if you don’t meet the criteria for condition code 44.
Speaker: Kimberly Anderwood Hoy, JD, CPC
Strategies to Ensure Medicare Compliance with Case Management and Physician Advisor Intervention
This session offers guidance to ensure CMS compliance and achieve revenue integrity. Learn how clinical and financial staff can unite to find solutions for observation services challenges.
Speaker: Joe Zebrowitz, MD
Meet the faculty
Deborah Hale, CCS, is president of Administrative Consultant Service, LLS, and has 25 years of experience in healthcare management, including administration, health information management, clinical documentation improvements, resource outcome management, and utilization review.Kimberly Anderwood Hoy, JD, CPC, is the lead instructor for HCPro's Medicare Boot Camp ®--Hospital Version and serves a lead consultant for HCPro's Revenue Cycle Institute. She is a former hospital compliance officer and in-house legal counsel and developed and implemented corporate-wide compliance programs for two hospitals.
Joe Zebrowitz, MD, is executive vice president and senior medical director of EHR in Newtown Square, PA. He also works as a physician advisor and medical director at EHR client hospitals, leading clinical denial management and length of stay programs, quality initiatives, documentation and compliance programs and independent peer review processes.
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SOURCE CODE: EHLM
