Contemporary Approaches to PEPPER: Support Revenue Integrity and Reduce Risk
Tuesday, April 11, 2017
1:00-2:30 p.m. Eastern
William L. Malm, ND, RN, CRCR, CMAS
Kurt Hopfensperger, MD, JD
Level of Program:
The Program for Evaluating Payment Patterns Electronic Report (PEPPER) is a treasure trove of data that can help hospitals adapt to the world of value-based purchasing, reduce risk, and stay ahead of audits. But understanding how to use and interpret this data can be challenging. PEPPER is an essential resource for a variety of different departments, including HIM, utilization review, coding, and internal auditing, but departmental silos mean hospitals may be missing out on the information it has to offer.
Join expert speakers William L. Malm, ND, RN, CRCR, CMAS, and Kurt Hopfensperger, MD, JD, as they identify and analyze PEPPER data, explaining three areas where PEPPER can help hospitals monitor coding outcomes. They will highlight and demonstrate educational opportunities provided by PEPPER and explain how to use the report to audit, monitor, and support revenue integrity in value-based purchasing, coding, and Medicare compliance.
At the conclusion of this program, participants will be able to:
- Identify relevant PEPPER data
- Analyze and calculate PEPPER data
- Explain three areas where PEPPER can help hospitals monitor coding outcomes
- Describe the educational opportunities offered by PEPPER
- Recognize the use of PEPPER in auditing and monitoring
- Explain PEPPER as a tool to support revenue integrity in value-based purchasing, coding, and Medicare compliance
Who Should Listen?
- Revenue integrity managers/staff
- HIM directors/managers
- Compliance officers
- Coding managers/staff
- Revenue cycle managers/staff
- Case management managers/staff
- Physician advisors
- CDI managers/staff
- Identifying and assessing data in PEPPER
- Getting and sharing your PEPPER
- Basic types of PEPPER
- The impact of regulations on PEPPER
- PEPPER data calculations
- Percentages vs. percentiles
- Understanding the denominator and the numerator
- How CMS uses PEPPER to find outliers
- The impact of PEPPER on revenue
- How PEPPER data improves success in value-based purchasing models
- The impact of PEPPER on risk-based scores
- How to use PEPPER to defend against external audits and guide internal audits
- PEPPER as an indicator of coding quality
- How to use PEPPER to drive and protect revenue
- Demonstrating process improvements
- Using PEPPER data for education
- Operationalizing PEPPER
- Case studies
- Medical necessity
Meet the Speakers
William L. Malm, ND, RN, CRCR, CMAS, is a managing director at Health Revenue Integrity Services. He is a nationally recognized author and speaker on topics such as healthcare compliance, chargemasters, and CMS recovery audits. Malm brings over 25 years of experience with a combination of clinical and financial healthcare knowledge that encompasses all aspects of revenue integrity. He also serves as the secretary/treasurer for the Certification Council of Medical Auditors. He has extensive experience with all postpayment audits, having previously worked as a systems compliance officer at a large for-profit healthcare system. Malm also co-hosts Appeal Academy’s “Finally Friday” discussions.
Kurt Hopfensperger, MD, JD, serves as vice president, compliance and physician education at EHR. Prior to joining EHR, he practiced for 14 years as a board-certified neurologist in several practice settings. Previously, Dr. Hopfensperger ran his own law practice in the Chicago area, in which he specialized in general medico-legal consultation, technical case review for malpractice and disability claims, and contract and payer cases. He remains actively licensed to practice law.
Webinar system requirements and program materials:
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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
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