The Effective Utilization Review Committee: Best Practices for Compliance
Product Description:
AUDIO CONFERENCE ON CD OR ON-DEMAND
Sponsored by: Medicare Compliance Forum
Presented on Tuesday, May 17, 2011
A utilization review (UR) committee isn't a luxury, it's a requirement.
Join us for this 90-minute audio conference and learn how to get physicians and essential team members to understand the need and engage in the process. Our speakers will help you establish an effective UR committee and show you how one hospital set measurable goals and expanded the role of its UR committee.
At the conclusion of this program, participants will be able to:
- Explain the regulatory requirements for the committee
- Identify appropriate members of the UR committee
- Describe strategies for getting physician buy-in
- Establish measurable goals for the UR committee
TAKE A LOOK AT THE AGENDA
- Identifying core functions of the UR committee
- Review medical necessity of inpatient admissions to hospitals and use of observation services
- Review professional services and medications
- Developing a committee
- Selecting team members
- Meeting content
- Frequency
- Obtaining physician buy-in
- Case study: Adding functions to the UR committee
- Setting goals and measuring results
- Connecting the committee to the rest of the organization
- Reviewing physician profiles
- Documentation
- A live question and answer session follows the presentation.
MEET THE SPEAKERS
John Zelem, MD, FACS, is senior director of audit, compliance and education for Executive Health Resources (EHR) in Newtown Square, PA. He has more than 25 years of clinical experience and is responsible for quality assessment and improvement at EHR’s client hospitals.
Gayle Dickerson, MSM, is director of Patient Management Services and Patient Access/Revenue Cycle at Baptist Hospital East in Louisville, KY. She has administrative responsibility for admissions, case management (including utilization review), social services, patient bed placement and revenue cycle.
WHO SHOULD LISTEN?
Case managers and directors, utilization review specialists, physician advisors, medical directors, VPMAs, CMOs, denials/appeals specialists, revenue cycle directors and managers, HIM directors and managers, quality improvement specialists, performance improvement specialists, CDI specialists, CFOs, compliance officers It's also a perfect training tool for new staff or as a refresher for veteran staff.
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