Outpatient Therapy Billing Challenges: Limit the Impact of Reduced Payments
Product Description:
AUDIO CONFERENCE ON CD OR ON-DEMAND
Sponsored by: Briefings on APCs
Presented on Tuesday, June 21, 2011
Outpatient Therapy Billing Challenges
CMS’ payment reduction for same-day multiple outpatient therapy services shrinks reimbursement on subsequent services by 25% for hospital outpatient settings and 20% for private practices. At the same time, other payers are aggressively reducing payment rates through contracting techniques as well as pre-payment and post-payment review.
During this 90-minute audio conference, you’ll learn how to adjust your practice to limit financial impact of payment reductions while remaining compliant with regulations and payer contracts.
Our speakers will explain CMS’ Multiple Procedure Payment Reduction Policy (MPPR) and its effects on both outpatient hospitals and therapy practices. They will show you how one facility responded to the payment reductions and maintained a high level of patient care.
NOTE: This is an intermediate-level program. Listeners should have a basic familiarity with rehab HCPCS and CPT codes and clinical documentation for rehab services
Learning Objectives
- Explain the difference between institutional provider and private practice under the MPPR
- Effectively respond to payers that “short pay”
- Develop a compliant plan to work with patients whose care is affected by payment reductions
- Effectively assess whether Medicare is second payer
Agenda
- CMS’ Multiple Procedure Payment Reduction Policy (MPPR)
- Difference between institutional provider and private practice CPT coding implications
- Effects on payer and provider communities
- Patient care ethics
- Case example
- Payer complexities
- Responding to payers that “short pay”
- Researching contract terms from payers that reduce reimbursement
- Therapy billing extenders and their compliance implications
- Medicare Secondary Payer (MSP)
- Questions to ask upfront
- Fraud implications
- OIG emphasis on claims
- Medicare/Medicaid integrity programs
- Case study: ATI Physical Therapy
- Detection of payer inaccuracies
- Payer challenges upfront: Understand the differences
- Medical necessity
- Effective management of denied claims
- A question and answer session follows the presentation.
MEET THE SPEAKERS
Nancy J. Beckley, MB, MBA, CHC, is president of Nancy Beckley & Associates LLC, a compliance consulting firm in Milwaukee, WI. She is certified in healthcare compliance and is recognized as an expert in rehab compliance planning and implementation.
Wade A. Meyer, PT, DPT, CHC, CSCS, is assistant compliance officer at ATI Physical Therapy in Bolingbrook, IL. He is certified in healthcare compliance and has experience as a therapy clinic director as well as clinical compliance manager responsible for handling denials for more than 100 therapy clinics with multiple payers.CONTINUING EDUCATION CREDITS
AAPC: 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.
AHIMA: This program has been approved for 1.0 continuing education unit for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).
BONUS MATERIALS INCLUDED IN YOUR MATERIAL PACKET
In addition to the expertise and information presented during this audio conference, you'll also receive these helpful “take-aways” provided within your materials pack:
- Claims audit checklist
- Sample rebuttal letter
WHO SHOULD LISTEN?
Outpatient therapy department managers and staff, outpatient coding staff, compliance staff, billing managers and staff, finance managers, clinical staff, HIM directors and managers, collections managers and staff, patient financial services
AUDIO ON-DEMAND
Purchase a CD or an audio on-demand of the audio conference 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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