Inpatient vs. Observation Status (Audio Conference)

AUDIO CONFERENCE ON CD OR AUDIO ON-DEMAND

Sponsored by Observation Status: A Guide to Compliant Site of Service Designations, Second Edition

presented on Thursday, August 28, 2008

When it comes to determining whether a patient should be admitted as an inpatient, outpatient, or observation patient, strict CMS guidelines are confusing at best. To make the process more complicated, observation criteria and requirements vary from one payer to the next, and hospitals will soon face greater admission scrutiny through CMS’ recovery audit contractors (RAC).

You can't afford to miss this 90 minute audio conference Inpatient vs. Observation Status: Managing Levels of Care to Ensure Compliance, Optimize Reimbursement, and Avoid Denials. Veteran speaker Deborah K. Hale, CCS discusses the new changes to observation status reimbursement for 2009 and brings you time-saving techniques and field examples to get you over your observation hurdles.

AGENDA

1. Easy steps for  level of care decision-making
   1. Beyond admission screening criteria
      1. Determining medical necessity of inpatient admission: Case studies
      2. Determining medical necessity of observation status: Case studies
      3. Determining medical necessity of outpatient procedures: Case studies
   2. Collaboration in level of care decision-making
      1. The role of the ED physician
      2. The role of the admitting physician
      3. The role of the case manager
      4. The role of the UR committee
      5. The role of the physician advisor
   3. Changing level of care orders
      1. Physician order for change
   4. Condition Code 44
      1. Provider liable claim
2. Updates to observation reimbursement for 2009
   1. Rules and regulations
   2. Observation APCs
3. Question and answer session

LEARNING OBJECTIVES

By the end of the program you'll be able to:

1. Discuss easy steps for level of care decision-making
2. Recognize key factors that support a medically necessary inpatient admission
3. Recognize key factors that support a medically necessary observation status admission
4. Identify internal processes for evaluating medical necessity of admission
5. Implement action steps for correcting level of care determinations
6. Identify 2009 proposed changes to observation regulations and reimbursement

FEATURED SPEAKER

Deborah K. Hale, CCS, president of Administrative Consultant Service, LLC (ACS), is a certified coding specialist with twenty five years of experience in health care management including administration, health information management, clinical documentation improvement, case management and utilization review.She is a member of the American Health Information Management Association and the Health Care Finance Management Association.

BONUS MATERIALS

In addition to the expertise and advice presented during this audio conference, you'll also receive a slide presentation of the program materials and:

• “Medicare patients: Observation or inpatient admission?” poster
• Related Medicare observation status reference newsletter
• MedLearn Matters article: MLN Matters number SE0622
• UR review document for recording advisory opinion
• Check sheet for Condition Code 44
• Nursing/case management acronym list for reference

WHO SHOULD LISTEN?

Directors of case management, case managers, UR nurses, physicians, revenue cycle managers.

HIM professionals, finance professionals, and coders may benefit from this program as a secondary audience.

AUDIO ON-DEMAND

In addition to the regular purchase option for HCPro audio conferences, we are pleased to offer another option, an 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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