AUDIOCONFERENCE ON CD OR AUDIO ON-DEMAND
Sponsored by Medicare Boot Camp – Hospital Version
presented on July 30, 2008
Ensure appropriate payment and avoid compliance traps
Medicare's three-day payment window provides both opportunity and risk for hospitals, and unless you completely understand this so-called "three day payment window" (sometimes also referred to as the "72-hour rule") you can miss out on the former and expose yourself to the latter. From a revenue recovery standpoint, your facility is entitled to separate reimbursement for some services performed on the day of a patient’s admission, but only under certain circumstances. Consequently, you must take steps to ensure you understand which outpatient services are separately billable and which must be included on the inpatient claim.
How can you remain in compliance with the rule as well as increase revenue opportunities?
Listen to HCPro's 90-minute audioconference, Demystify Medicare’s Three-Day Payment Window: Understand the Rule and Maintain Best Practices. Healthcare compliance specialist Hugh Aaron (senior advisor, HCPro, Inc.) addresses the compliance perils surrounding the rule, as well as recent changes in CMS policy, including the rules that determine whether an outpatient pre-admission service is separately billable.
In addition to this analysis, Catherine Coughlin (director for regulatory compliance support, HCA Inc.) discusses how her organization operationalized the three-day payment window rules, changed policies and procedures, and achieved compliance.
AT THE END OF THIS AUDIOCONFERENCE YOU WILL BE ABLE TO:
- Create a process in which different departments work together to achieve compliance with the three-day payment window rule
- Determine when the rule applies and does not apply to services furnished by an affiliated entity
- State how revenue code assignment and ICD-9-CM coding affects compliance and payment under the rule
- Explain why the so-called "three-day window" is really a four-day rule
- Discover why hospitals may be getting under-reimbursed for Emergency Department services furnished on the day of an inpatient admission
- Explain recent CMS "clarifications" of the rule
- Operationalize the rule to ensure compliance and appropriate payment
AGENDA
- Mechanics and recent CMS clarifications
- Who furnished the preadmission services
- When were the preadmission services furnished
- What types of services were furnished
- When are non-diagnostic services considered to be "related"
- Medicare contractors and line item date of service
- Revenue code and CPT code changes to define diagnostic services
- Compliance traps and revenue opportunities
- Inappropriate outpatient payments for preadmission services
- Overstated inpatient outlier payments
- Underpayment for outpatient preadmission services
- Operationalizing the rule: The HCA experience
- Strategies to bring together various departments toward a common goal
- Initiating consolidated billing and coding policy for the three-day payment window
- Steps to ensure services are reviewed and coded and billed appropriately
- Automating the patient accounting process
- Managing with a different system in wholly owned clinics
- Integrating all patient accounting systems
- Q&A
BONUS MATERIALS
In addition to the expertise and advice presented during this audioconference, you'll also receive: a slide presentation of the program materials and:
- HCA consolidated coding & billing policy
- Regulations- updated to this year
These materials are provided with PDF links.
MEET THE SPEAKERS
Hugh E. Aaron, MHA, JD, CPC, CPC-H. Aaron is HCPro's senior advisor. His work focuses primarily on coding and billing accuracy with a particular emphasis on Medicare billing compliance. Aaron practiced health law for 13 years and was the founder and president of HRAI Coding Specialists, LLC, a national coding and billing training firm where he developed the Boot Camp series now offered by HCPro.
Catherine Coughlin. Coughlin is the director for regulatory compliance support at HCA Inc. in Nashville, TN. She provides operational support, education, regulatory research and monitoring related to billing compliance for federally funded payers. Coughlin has an extensive healthcare background, with experience in an anesthesiology group, a medical billing company, a free-standing psychiatric facility and an acute care hospital.
WHO SHOULD LISTEN?
Professionals based in hospitals and provider-based clinics, including representatives from the following departments, or position titles:
- Reimbursement and finance
- Compliance officers
- HIM (coding and billing)
- Revenue cycle
- Business office/patient accounts
- Legal counsel
- Leadership
- Corporate management (CEO, COO, CFO, CIO)
AUDIO ON-DEMAND
In addition to the regular purchase option for HCPro audioconferences, we are pleased to offer another option, an audio on-demand. Audio on-demand allows you to download the program and play it back at your convenience through your computer or MP3 player. Purchase a CD or audio on-demand of the program and listen when you can. It's also a perfect training tool for new staff or as a refresher for veteran staff.
Save money when you purchase multiple copies! Ask your customer service representative about money-saving
discounts and bulk orders. Call toll free 800-650-6787 or e-mail
customerservice@hcpro.com.
