Provider-Based Department Compliance and Reimbursement Virtual Workshop

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Provider-Based Department Compliance and Reimbursement Virtual Workshop - On-Demand

Product Code: YZHHA121217D

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Provider-Based Department Compliance and Reimbursement Virtual Workshop - On-Demand

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Available ON-DEMAND

Presented on:
Tuesday, December 12, 2017

Presented by:
Kimberly A. Hoy Baker, JD, CPC

Level of Program:

Provider-based department regulations continue to evolve, and the changes ahead for 2018 are no exception—making it hard to ensure appropriate reimbursement and remain compliant. Keep your entire team on top of the latest in provider-based determinations, claims issues, modifiers, and more with this live virtual workshop.

During the first part of this three-hour on-demand workshop, Medicare regulatory expert Kimberly A. Hoy Baker, JD, CPC, will help participants break down recent changes and developments.

The second part of the workshop will offer insight into 2018 outpatient prospective payment system final rule changes that may impact provider-based departments as of January 1. Reimbursement under Section 603 of the Bipartisan Budget Act of 2015 and an analysis of freestanding versus provider-based departments will also be covered in this part of the program.

The final part of the workshop will contain case-study discussions of provider-based claims issues and will include explanations of the proper application of modifiers for provider-based departments.

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

  • Discuss recent provider-based department developments
  • Explain how provider-based department determinations are made
  • Describe the differences in reimbursement for provider-based and freestanding clinics
  • Describe the impact of Section 603 of the Bipartisan Budget Act of 2015 on off-campus departments
  • Apply modifiers to specific provider-based department scenarios

Who Should Listen?

  • Providers
  • Clinic directors and managers
  • Coders
  • Coding managers
  • Billers
  • Billing managers
  • Compliance directors, managers, and staff
  • Auditors
  • CFOs and finance directors
  • Revenue cycle directors and professionals
  • Revenue integrity professionals
  • HIM directors and managers
  • Physician practice administrators


  • Part I: Recent developments
    • Proper reporting of the service address
    • Provider-based determinations and new CMS checklists of requirements
    • Supervisions
  • Part II: Changes in reimbursement
    • 2018 OPPS and MPFS final rule updates
    • Ask questions to prepare for January 1 rule implementation
    • Analyzing reimbursement in provider-based departments
    • Freestanding versus provider-based
    • On-campus versus off-campus department reimbursement
  • Part III: Examples of claims and modifiers
    • Claims formatting and issues for outpatient claims involving PBDs
    • Applying modifiers

Continuing Education

American Health Information Management Association (AHIMA)
(Live + On Demand) - This program has been approved for 3.0 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: 12/11/18)

Meet the Speaker

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 HCPro's Revenue Cycle Advisor and is the lead instructor for HCPro's Medicare Boot Camp®—Hospital Version, Medicare Boot Camp®—Utilization Review Version, and HCPro’s Medicare Boot Camp®—Provider-Based Department Version. She is a former hospital compliance officer and in-house legal counsel and has over 25 years of healthcare experience, including 10 years of experience teaching, speaking, and writing about Medicare coverage, payment, and coding regulations and requirements.

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. 

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 $399 value! 

Participation in the webinar is just $399 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.