PEPPER: Reduce Risk and Improve Revenue Integrity - On-Demand
Wednesday, August 3, 2016
(Original broadcast Tuesday, April 26, 2016)
William L. Malm, ND, RN, CRCR, CMAS
Kurt Hopfensperger, MD, JD
Revenue Cycle Daily Advisor
Level of Program:
With the ongoing audits pertaining to the 2-midnight rule and the potential for more severe penalties, a comprehensive Program for Evaluating Payment Patterns Electronic Report (PEPPER) is, now more than ever, a great benchmark for overall readmission reduction and value-based purchasing.
During this on-demand program, expert speakers William L. Malm, ND, RN, CRCR, CMAS, and Kurt Hopfensperger, MD, JD, explain the most up-to-date information on PEPPER for 2016, including the addition of the defibrillator implant category, and break down what the report means for hospitals. Attendees will discover advanced techniques for transforming raw PEPPER data into a powerful tool for risk reduction, defense against external audits, and proactive internal audits. They’ll also learn how PEPPER can be used to protect and improve revenue integrity, as well as refine operational processes and measurements. Case studies give real-life context to theories and techniques.
At the conclusion of this program, participants will be able to:
- Analyze and assess key information in PEPPER
- Learn how to use PEPPER as an audit and risk reduction tool
- Demonstrate how PEPPER is used to evaluate and improve performance
- Construct processes to put PEPPER to work for their facility
- Show how PEPPER predicts and explains the actions of CMS and Recovery Auditors
- Recognize how PEPPER is used to ensure overall success and Medicare compliance
Who Should Attend?
- Revenue cycle directors and managers
- Case managers
- Care management managers
- HIM directors and managers
- HIM staff
- Clinical documentation improvement professionals
- Billing and coding managers and staff
- Internal auditors
- Getting the most out of PEPPER
- Identifying percentages vs. percentiles
- Selecting who has access to your PEPPER data
- How to get your facility’s PEPPER
- How Medicare uses PEPPER to find outliers
- Understanding the denominator and numerator
- Deploying PEPPER for audits
- How to validate PEPPER data using hospital charts
- Using PEPPER
- Revenue management
- Value-based purchasing
- Process improvement
- Operational measurements
- Case studies: Medicare’s logic for PEPPER
- Medical necessity
- One-day medical stays
- Spinal fusion
- Simple pneumonia
- Seven tips for PEPPER success
- Q&A (not live)
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: 4/25/2017)
(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: 3/31/2017)
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. Previously, Malm played a key role in providing revenue integrity and data expertise for Craneware, Inc., the market leader in revenue integrity software solutions. 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 as a board-certified neurologist, serving as the medical director of patient safety and chair of the employed physician group at Cheyenne Regional Medical Center, as well as in private practice with Wyoming Neurology, Cheyenne Medical Specialists, and Medical Arts Associates in Moline, Illinois. Previously, Dr. Hopfensperger also 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.
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