Inpatient Admissions and the 2-Midnight Rule: Your Questions Answered

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Inpatient Admissions and the 2-Midnight Rule: Your Questions Answered

Product Code: YHHA112817

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Inpatient Admissions and the 2-Midnight Rule: Your Questions Answered

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Loyal Listener Library

Presented on:
Tuesday, November 28, 2017
1:00-2:30 p.m. Eastern

Presented by:
Kimberly A. Hoy Baker, JD, CPC
Ralph Wuebker, MD, MBA

Level of Program:
Intermediate

The complexities of the 2-midnight rule continue to challenge hospitals. In this 90-minute webinar, specific cases will be discussed, easing confusion for healthcare facilities and helping them ensure compliance with the rule’s application.

During this interactive program, expert speakers Kimberly A. Hoy Baker, JD, CPC, and Ralph Wuebker, MD, MBA, will discuss Medicare inpatient admission requirements, utilization review, and patient status and medical necessity regulatory updates. They will then respond to pre-submitted and live audience questions, giving facilities insight into the unique challenges they face with inpatient admissions. Tricky scenarios, including unsafe discharges and the 3-midnight requirement for covered skilled nursing facility placement, will also be addressed.

At the conclusion of this program, participants will be able to:

  • Explain how to handle admissions for patients in observation
  • Identify strategies for managing transfers under the 2-midnight rule
  • Recognize inpatient-only cases and explain how to handle them


Who Should Listen?

  • Utilization review staff
  • Utilization review nurses
  • Utilization review physician advisors
  • Case managers
  • Hospitalists
  • CDI physician advisors
  • Revenue cycle and revenue integrity professionals
  • Compliance managers and staff
  • HIM directors, managers, and staff
  • Billing managers


Agenda 

  • Part 1: Medicare inpatient admission requirements
    • Review of the CMS BFCC-QIO 2-midnight claim review guideline
      • Learn how to determine whether an inpatient qualifies for a claim payable under Medicare Part A
      • Understand how an auditor should look at inpatient-only admissions under the 2-midnight rule
      • Review OIG report on long observation stays
    • Explanation of inpatient admission requirements under the 2-midnight rule
      • Learn how to identify inpatient-only cases
      • Understand admission requirements for:
        • Short-stay admissions
        • Inpatient-only cases
        • Patients in observation
      • Recognize the unforeseen circumstances and exceptions to the 2-midnight rule, including shorter length of stay than expected, transfer, departure against medical advice, election of hospice care, and death
  • Part 2: 2-midnight and medical necessity Q&A session with experts, including:
    • Live Q&A with audience
    • Pre-submitted audience questions
    • Questions commonly received by the speakers


Tools

  • BFCC QIO 2 Midnight Claim Review Guideline – CMS


Continuing Education

AAPC
(Live + On Demand) - This program has the prior approval of AAPC for 1.5 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor. (Ability to claim CEH’s for this webinar expires on: 11/27/18)

Accreditation Council for Continuing Medical Education (ACCME)
(Live webcast participant only) - HCPro is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

HCPro designates this educational activity for a maximum of 1 AMA PRA Category 1.5 CreditsTM. Physicians should only claim credit commensurate with the extent of their participation in the activity. 
(Ability to claim CEU’s for this webinar expires on: 11/27/2018)

American Health Information Management Association (AHIMA)
(Live + On Demand) - This program has been approved for 1.5 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor. (Ability to claim CEU’s for this webinar expires on: 11/27/18)

American Nurses Credentialing Center (ANCC)
(Nursing contact hours valid for live webcast participant only) - HCPro is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

This educational activity for 1.5 nursing contact hours is provided by HCPro.
(Ability to claim nursing contact hours for this webinar expires on: 11/27/2018)


Meet the Speakers

Kimberly A. Hoy Baker, JD, CPC

Kimberly A. Hoy Baker, JD, CPC, is the director of Medicare and compliance for HCPro. She is a lead regulatory specialist for the HCPro Revenue Cycle Institute and is the lead instructor for HCPro’s Medicare Boot Camp®—Hospital Version and Medicare Boot Camp®—Utilization Review Version, as well as an instructor for Medicare Boot Camp®—Critical Access Hospital Version. She is a former hospital compliance officer and in-house legal counsel, and has developed and implemented corporatewide hospital compliance programs. In addition, Baker has experience conducting billing, compliance audits, and internal investigations.

Ralph Wuebker, MD, MBA

Ralph Wuebker, MD, MBA, is chief medical officer for EHR in Newtown Square, Pennsylvania. He is board certified and currently serves as a member of EHR’s physician education and audit team. Wuebker regularly visits EHR’s client hospitals to provide medical executives and staff members with ongoing education on a variety of topics, including Medicare and Medicaid compliance and regulations, medical necessity, recovery audit contractors, utilization review, denials management, and length of stay.


Webinar system requirements and program materials: 
To fully benefit from the webinar experience, please note you will need a computer equipped with the following:

Browser: Microsoft Internet Explorer 6 or later, Firefox, Chrome, or Safari, with JavaScript enabled 
Internet: 56K or faster Internet connection (high-speed connection recommended) 
Streaming: for audio/video streaming, Adobe Flash plug-in or Safari browser on iOS devices 

Prior to the webinar, you will receive an email with detailed system requirements, your login information, presentation slides, and other materials that you can print and distribute to all attendees at your location. 

CAN'T LISTEN LIVE? 
No problem. The On-Demand version is now available. Use it as a training tool at your convenience—whenever your new or existing staff need a refresher or need to understand a new concept. Play it once or dozens of times. A $259 value! 

PLEASE NOTE 
Participation in the webinar is just $259 per site. All materials must be retrieved from the Internet. 

Call your customer service representative toll-free 800-650-6787 or email customerservice@hcpro.com if you have questions.