Inpatient-Only Procedures: Strategies to Ensure Revenue Integrity - On-Demand

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Inpatient-Only Procedures: Strategies to Ensure Revenue Integrity - On-Demand

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Inpatient-Only Procedures: Strategies to Ensure Revenue Integrity - On-Demand

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Available ON-DEMAND.

Presented on: 
Thursday, June 23, 2016

Sponsored by: 
Inpatient-Only Procedures Training Handbook

Inpatient-only procedures are governed by complex Medicare billing rules and require staff in multiple departments—patient access/registration, billing, CDI, compliance, and more—to work together to ensure these procedures are handled and billed for correctly. Hospitals can lose significant revenue if an inpatient-only procedure is scheduled and performed without an inpatient order. Emergency procedures and procedures that are converted to inpatient-only midway through the surgery add another layer of complexity to creating and following policies. Multiple checks need to be established throughout the system to prevent denials, and special exceptions to Medicare's rules require staff to understand exactly when and how they apply.

Although the expansion of the three-day payment window has alleviated some problems, it’s also ushered in other questions and the need for process improvements and robust reviews. And because surgeons' payments are not affected by inpatient-only payment rules, it can be difficult for hospitals to ensure they understand and follow their own policies.

During this program, your speaker will explain the inpatient-only rules and how to create processes to catch inpatient-only procedures performed on an outpatient basis before they’re denied. She’ll discuss exceptions to the rules, how to identify and bill for them, and what documentation must be obtained. She will also explain how to optimize staff involvement and education, and how to establish a program that ensures success and revenue integrity. Listeners will receive detailed guidance on best practices as well as a departmental checklist breaking down the role each department and staff member plays in supporting compliance.

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

  • Understand the inpatient-only regulation, its purpose, and where to find source documents to implement a compliant process 
  • Understand the impact on revenue when the regulation is not appropriately applied 
  • Identify key personnel who can assist in resolving process problems 

Who Should Listen? 

  • HIM directors and managers 
  • Compliance officers 
  • Case managers 
  • CDI professionals and staff 
  • Revenue cycle managers 
  • Billing managers 
  • Coding managers 
  • Physicians 
  • Surgeons 
  • Physician practice office managers 
  • OR and scheduling team members 
  • Utilization review team members 
  • Patient access/registration managers 


  • Understand what the regulation is, its financial impact, and why hospitals are held accountable rather than physicians 
    • What is the inpatient-only regulation? 
    • Finding and using the inpatient-only list 
    • The effects on reimbursement 
    • Exceptions to the general rule 
  • Identify who should be part of a broad education plan—a top-down and across strategy 
    • Key stakeholders in the inpatient-only process 
    • Gaining support from the top down 
    • Repeat and integrate education 
  • Identify different points of entry into the hospital where process problems may occur 
    • Registration, surgery scheduling, and the clinical setting 
    • CDI, UR, and case management 
    • Coding, billing, and auditing 
    • Denials management 
  • Support success and incentivize staff 
    • Outreach and communication 
    • Demonstrate the roles of various staff in the inpatient-only process 
    • Achieving the maximum response 
  • Q&A (not live)

Continuing Education

(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. (CEH’s for this webcast expire on: 6/22/17)

American Health Information Management Association (AHIMA)
This live program has been approved for 1 continuing education unit 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. (CEU’s for this webcast expire on: 6/22/2017)

Webcast system requirements and program materials: 

To fully benefit from the webcast 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 webcast, 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. 

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! 

Participation in the webcast 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 if you have questions.