PEPPER 2011: Identify Changes, Address Vulnerabilities, and Be Audit-Ready
Product Description:
AUDIO CONFERENCE ON CD OR ON-DEMAND
Sponsored by: Certified Coder Boot Camp® - Inpatient Version
Presented on Thursday, June 23, 2011
The newly designed PEPPER is a free resource not to be ignored. Learn how to work with this report and the new measures for 2011 to create targeted education and training to improve your organization’s Medicare claims profile.
During this two-hour audio conference, our experts will discuss hot topics, including the addition of two-day stay measures for medical necessity and confusion about unrelated OR procedures. They will show you how to examine practice patterns identified by your organization’s PEPPER data to highlight potential areas of external audit risk. Once you understand the relevance of your data and how to analyze it, you’ll be able to incorporate more proactive practices in your revenue cycle and be better prepared for potential government audits. Bring your PEPPER data and ask questions.
Note: If you are a critical access hospital, be sure to participate in the July 7 PEPPER for Critical Access Hospitals audio.
At the end of the program you will be able to:
• Interpret PEPPER data and identify important changes to the reports for 2011
• Translate vulnerabilities identified by PEPPER into organizational or departmental process changes
• Implement innovative methods to educate staff on PEPPER, targeting specific audiences with topics relevant to their scope of practice and areas of expertise
TAKE A LOOK AT THE AGENDA:
I. PEPPER data basics
a. Organizational access to PEPPER data
b. PEPPER statistics - numerator/denominator
II. 2011 PEPPER changes
a. Expansion from one-day stays to monitoring high-risk two-day stays
b. Addition of high-risk DRGs
c. Excisional debridement
c. Unrelated OR procedures
d. Ventilator support
e. Separation of medical and surgical CC/MCCs rates
f. Separation of readmissions to same facility and different facilities
III. Using PEPPER to identify and address vulnerabilities
a. Identifying high-risk practice patterns
b. Setting organizational expectations
c. Identifying coding/documentation vulnerabilities and opportunities
IV. Exploiting the relationship between PEPPER data and government audits
a. DRG complex reviews
b. Medical necessity
c. Readmissions
V. Innovative ways to educate staff on PEPPER
a. RAC committee meetings
b. Coding roundtables
c. Medical staff meetings
d. Utilization review meetings
VI. Targeting PEPPER data reviews to specific audiences
a. Compliance
b. RAC teams
c. Revenue integrity
d. Utilization review / case management
e. CDI
f. Quality
g. Medical staff
h. Data analytics
i. Coding/HIM
j. Administration/hospital leadership
A question and answer session will follow the presentation.
MEET THE SPEAKERS:
Donna D. Wilson, RHIA, CCS, CCDS, is a senior director in the consulting divison of Compliance Concepts, Inc., in Wexford, PA, where she assists providers in RAC initiatives and develops best-practice clinical documentation improvement and revenue integrity programs. She has more than 29 years experience in the coding quality/health information management field.
Cheryl Ericson MS, RN, manages the clinical documentation integrity (CDI) and utilization review (UR) departments at a large academic medical center, The Medical University of South Carolina (MUSC), in Charleston, South Carolina. She has an extensive background in adult education, data analysis, healthcare revenue cycle, and CMS guidelines.
CONTINUING EDUCATION CREDITS
AAPC: This program has prior approval of the American Academy of Professional Coders for 2.0 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 2.0 continuing education unit for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).
CCDS: This program has been approved for 2.0 continuing education units towards fulfilling the requirements of the Certified Clinical Documentation Specialist (CCDS) certification, offered as a service of the Association of Clinical Documentation Improvement Specialists (ACDIS).
MATERIALS
In addition to the expertise and advice presented during this audio conference, you'll receive a slide presentation of the program materials and valuable takeaways, which you can use at your facility, including and audit plan.
WHO SHOULD LISTEN?
Directors and managers in coding/HIM, compliance, CDI, utilization review/case management, quality, medical staff, data analytics
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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