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Maximizing & Protecting Your Hospital's Revenue Integrity: Three-Part AudioConference Series
Who Should Participate
Compliance officers, hospital legal counsel, risk managers, reimbursement specialists, CFOs, business office managers, coding specialists, health information management staff, nurse managers, CDM coordinators.
Part 1
Charge Masters Are Easy - It's the Charge Capture That's Tough
June 23
9 - 11 am
Charge masters (CDMs) may have all the right codes and charges, but they aren't getting used. How knowledgeable are your department heads about what should be billed for what services? Is your facility "thinking outside the traditional box" to explore ways to get the correct charges on the bill? This session identifies numerous new approaches to charge capture, including department specific monthly charge/chart/audits, UB-04 itemized reviews, and coder/charge capture analyst pods. The speaker will also address computer "rejects" when combinations are not present, and methods for interviewing all employees responsible for charge entry - either manual or electronic. A focus on daily auditing, as well as ongoing education, will be discussed as some of the keys to individual department ownership. Lastly, this session will present concepts around the patient friendly CDM, e.g. looking at the CDM through "patient colored glasses." Patient friendly CDM examples will be given, and the importance of reassessing your hospital's charging communication pattern will be discussed.
Part 2
ER & Hospital-Based Clinics - Challenges & Hidden revenue Strategies
July 15
9 - 11 am
Understanding evaluation and management (E&M) criteria, procedure billing, charge master issues, and how the coding dilemma can be addressed are all part of this operational-based training. Participants will gain insight into when to hard code versus when to have health information management (HIM) do the coding. Should nursing or a separate entity complete the E&M? What is a hospital-based clinic (HBC)? What is the best way to get the charges on the bill? These are just some of the questions that will be addressed during this audio conference. Drug administration challenges will also be included,
Part 3
Observation - The Challenges of Coverage & Compliance
July 17
9 - 11 am
Observation (OBS) is not a mini inpatient. It is an outpatient in a bed that requires active physician involvement to reduce potential lost hours. Nursing leadership's role is critical, as it is all about the story in the record. Utilization review provides guidance with patient status vs. nursing's leadership: billable hours are key elements in this class. To ensure compliance, all aspects of coverage must be addressed: order, intent in the order, medical necessity for each billable hour, active physician involvement, and bedside nursing's leadership role. This session walks through why we should love observation and some keys to success: dedicated beds, drug administration tools to capture lost revenue, as well as operationalizing active physician involvement ideas. Learn how to implement an OBS "attack team" with daily team auditing - for compliance in billing and prevent work with RAC.
Faculty
Day Egusquiza
Day Egusquiza brings over 28 years experience in health care reimbursement, business office operations, contracting, and compliance implementation. Additionally, her experience includes eight years as a director of a physician medical management billing service. She has been an entrepreneur in hospital and physician practice accounts receivable management, and a leader in redesigning numerous organizations. Her work includes providing insight and guidance as a compliance, HIPAA, and APC educator to department heads, as well as business operations staff. Egusquiza is a nationally recognized speaker on continuous quality improvement (CQI), benchmarking, redesigning, reimbursement systems and implementing an operational focus of compliance-both in hospitals and practices. She has been on the AAHAM national advisory council, HFMA national advisory council, HFMA faculty, CCH reimbursement advisory board, and is a past president of the Idaho HFMA chapter. She has been highlighted in The Joint Commission's Six Hospitals in Search of Excellence; Zimmerman's Receivable Report and Health Care Biller; HFMA's HFM & Patient Accounts, as well as other health care publications.
The views expressed by the speaker do not necessarily reflect the policies or opinions or the Wisconsin Hospital Association.
Register for this event online:
Registration Information
Fee
Per Session Fee: $295.00 for one phone line per site
Entire Series: $595.00 for one phone line per site
Please register only one name per connection.
Additional phone lines will be billed at $295.00 each.
How the AudioConference Will Work
Dial-in instructions, on-line login instructions and any other reference materials will be emailed to each registrant approximately three days prior to the conference. If you do not receive them by this date, please email llittel@wha.org.
It is the responsibility of the registrant to access presentation materials prior to the day of the event. If your e-mail address changes, you do not receive an e-mail with instructions from WHA, or if you are unable to open presentation materials, please contact Lisa Littel at WHA two days prior to the event to allow time to address the issue.
Substitution, Transfer and Cancellation Policy
Cancellations received in writing up to five business days prior to an event will be given a full refund less a $50 processing fee. No refunds will be given for cancellations received less than five business days prior and day-of-program no-shows. Substitutions are accepted.
Register for this event online:
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