Capturing Costs of Outpatients in Beds
Product Description:
AUDIO CONFERENCE ON CD OR AUDIO0-ON-DEMAND
Sponsored by JustCoding
presented on June 10, 2010
There are multiple challenges when billing for outpatients in beds, particularly accounting for costs of resources utilized. In recent guidance, CMS has clarified its position on billing when observation criteria are not met and counting hours when also providing services requiring monitoring, such as complex drug administration. These clarifications create a maze of challenges for coding and billing professionals.
During this 90-minue intermediate-level audio conference, our experts discuss practical implementation tips to count observation and other outpatient hours. They break down several confusing examples and types of services, and show you how to properly report charges for compliant payment.
LEARNING OBJECTIVES
At the conclusion of this audio conference, you will be able to:
- Explain how to properly bill for extended recovery hours and for all hours of outpatient services
- Describe how to correctly count hours of observation, including proper exclusion of services requiring active monitoring
- Properly formulate the bill when condition code 44 applies and when it does not apply
- Identify lost outpatient bed hours
- Implement proven strategies for compliant billing of outpatient bed time
AGENDA
- Capturing costs for outpatients in beds
- OPPS packaging of outpatient bed time
- OPPS v. non-PPS (e.g., critical access, waiver)
- Definitions of services for outpatients in a bed: observation, active monitoring, and packaged services
- EHR and CPOE (computerized practitioner order entry)
- Proper billing and coding for outpatients in beds
- HCPCS coded services
- Packaged services
- Revenue code selection
- Counting observation time for compliant payment
- CMS clarification on active monitoring
- Documentation
- Operational strategies
- Applying condition code 44
- Outpatient bed time v. observation
- Rules for reporting Part B only
- CMS clarification on timing rules
- Operational implementation tips
- Case studies
MEET THE SPEAKERS
Kimberly Anderwood Hoy, JD, CPC, is the director of Medicare and Compliance for HCPro. She is the lead instructor for the Medicare Boot Camp®-Hospital Version and serves as the manager overseeing HCPro's Medicare Boot Camps. She is a consultant for HCPro's Revenue Cycle Institute, specializing in regulatory guidance on coverage, billing and reimbursement. She has particular expertise in patient status issues and provider-based entities.
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 HCPro's APC Weekly Monitor.
MATERIALS
In addition to the expertise and advice presented during this audio conference, you'll also receive a slide presentation of the program materials. These materials are provided with PDF links.
WHO SHOULD LISTEN?
HIM directors, managers, and coders; billing managers and staff; business office managers and staff; compliance officers; revenue cycle managers and staff; revenue integrity managers and staff; admission directors and registration staff.
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.
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