Critical Access Hospital and Rural Health Clinics Reimbursement Virtual Symposium -
On-Demand

Now Available On-Demand

Critical access hospitals (CAH) and rural health clinics (RHC) face a variety of unique challenges, many of which have been exacerbated by the COVID-19 pandemic and public health emergency. Specific Medicare coding and billing requirements, a typically older and sicker patient population, and staffing shortages can make accurate documentation and reimbursement difficult even in the best of times.

The Critical Access Hospital and Rural Health Clinics Reimbursement Virtual Symposium will allow CAH and RHC teams the opportunity to learn the latest strategies for managing Medicare policies without leaving the office. Experts will cover topics including emergency department documentation and billing, how to receive proper reimbursement for telehealth services, and quality/HCC reporting, as well as offering live Q&As where you can get feedback on your most pressing questions.

During the Critical Access Hospital and Rural Health Clinics Reimbursement Virtual Symposium you can earn valuable CEUs and have the opportunity to ask questions of our expert speakers. Plus you can network with your colleagues and peers from our easy-to-use event platform!

Registration includes a 60-day access period to the platform.

Critical Access Hospital and Rural Health Clinics Reimbursement Virtual Symposium -
On-Demand

Agenda

(45 minutes)
Health Information Management Workflow For CAHs and Rural Hospitals
Darice Gryzbowski, MA, RHIA, FAHIMA
This session will detail the patient flow cycle, critical electronic and/or paper workflow in managing the medical record documentation need in CAH and rural hospitals. It will examine the pros and cons of utilizing outsourced and in-house staff, collaborative/shared and remote staffing models, as well as consultants to assist in assuring a complete, compliant, and current record. Topics such as the role of clinical documentation integrity, coding, medical transcription, and other workflow functions will be discussed.

Learning Objectives:

• Optimize medical documentation workflow
• Determine the value of remote and outsourced staffing models
• Describe the role of CDI in ensuring compliant medical records

(45 minutes)
Reporting Telehealth Services and COVID-19 During the Public Health Emergency
Sandy Giangreco Brown, RHIT, CCS, CCS-P, CHC, COC, CPC, CPC-I, COBGC, PCS
COVID-19 has put an unprecedented amount of pressure on hospitals and health systems to stay up to date on near-constant regulatory and clinical changes, especially CAHs.

This session will identify the most recent regulatory changes regarding the public health emergency, identify where to find the resources which are constantly updated, as well as discussing relevant diagnosis coding guidelines effective January 1.

The session will also review the telehealth service updates impacting CAHs and provide the most current information possible.

Learning Objectives:

• Identify documentation requirements that need to be met to support coding of these diagnosis and procedures for COVID-19 and telehealth
• Review the updated COVID-19 guidelines for CPT coding and where to find the most current resources
• Discuss the COVID-19 diagnosis coding updates for January 1, 2021

(45 minutes)
What CAHs Need to Know About the 2021 E/M Coding Guidelines
Susan Rohde, RHIT, CCS-P, CPC
The 2021 E/M guideline updates are the most extensive to hit these commonly reported services in more than 20 years. This session with review how code selection for visits has changed and what physicians will need to document so that the appropriate visit level can be reported. The speaker will discuss how the new guidelines handle the visit components of time and medical decision-making (MDM). The session will also provide instruction for updating and revising electronic health record (EHR) templates to accurately represent the changes.

Learning Objectives:

• Explain the difference between 1995/1997 E/M and 2021 E/M guidelines
• Understand the importance of documentation
• Describe how medical necessity applies to the new guidelines
• Discuss Relative Value Unit (RVU) impact
• Provide next steps for facilities

(45 minutes)
Why CDI Matters for Critical Access Hospitals and Providers
Joy Krush, RHIT, CCS, CCS-P, CDIP
Complete and accurate medical record documentation is the cornerstone of compliant billing and coding. Beyond the clinical implications, it can also impact reimbursement and quality scores. This session will delve into how to use CDI at your facility. It will also explore the impact of risk adjustment and Hierarchical Condition Categories (HCC) on documentation and reimbursement.

Learning Objectives:

• Explain documentation impact on reimbursement and quality
• Describe documentation impact on Hierarchical Condition Categories (HCC)
• Leverage technology for documentation
• Determine what to include in coding and documentation policies
• Understand who is auditing clinical documentation

(45 minutes)
Q&A
Sandy Giangreco Brown, RHIT, CCS, CCS-P, CHC, COC, CPC, CPC-I, COBGC, PCS; Darice Gryzbowski, MA, RHIA, FAHIMA; Joy Krush, RHIT, CCS, CCS-P, CDIP; and Susan Rohde, RHIT, CCS-P, CPC

(45 minutes)
CAH Chargemaster Tips for Success
Rachel Pugliano, RHIT, CHC
Updating the chargemaster at a hospital is something that must be performed annually and accuracy can have a big impact on reimbursement. Learn essential policies and procedures for maintaining an accurate chargemaster—as well as how a revenue integrity department can aid these efforts—during this session. It will also cover which teams should be responsible for EHR and charge capture accuracy to ensure compliance.

Learning Objectives:

• Identify policies & procedures helpful in set-up and maintenance of the chargemaster
• Determine the roles and responsibilities associated with the upkeep of the CDM, charge capture, coding, billing and revenue integrity functions
• Review best practices for CDM maintenance, updates and charge capture
• Understand at a high level how the chargemaster relates to the cost report

(45 minutes)
Comply with Provider-Based Billing Rules
Deyon Suchla
Provider-based billing rules are complex and can require education all across the revenue cycle—from registration through coding and billing. This session will cover how to follow attestation requirements for provider-based billing, discuss how to combine services from multiple locations, and increase public awareness to improve payments and collections.

Learning Objectives:

• Follow the requirements for attestation
• Report services from multiple locations and explain Method II billing
• Improve processes for payments and collections

(30 minutes)
Rural Health Clinic Reporting for Certain Visits and Incident-to Services
Joe Rivet, Esq., CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO
Patient visits are a high volume and commonly reported service at rural health clinics. But the type of visit and services provided can determine how the claim should be reported—as well as which provider can be billed. This session will review coverage and billing for preventive services, mental health visits, and other types as of special services, as well as delving into incident-to billing and related staffing requirements.

Learning Objectives:

• Describe coverage and billing requirements for a medical visit and mental health visit
• Explain coverage and billing requirements for preventive services
• Determine coverage and billing for special services, including diagnostic services, vaccines, injections
• Understand incident-to services

(45 minutes)
Coding COVID-19 Therapies and Vaccines for Pharmacies
Cheryl Hetland, MA, 340B ACE
Pharmaceutical manufacturers are working feverishly to test medicines and develop new treatments to move them through clinical trials and FDA approval for use in humans. This session will identify the most-recent pharmaceutical vaccines and therapeutics approved for the treatment and prevention of COVID-19 and discuss billing and reimbursement considerations. The session also will explore changes to the 340B drug discount program that could affect reimbursement at your facility.

Learning Objectives:

• Identify the different types of COVID-19 vaccines available and discuss coding and reimbursement.
• Identify the different types of COVID-19 drug therapies available and discuss coding and reimbursement
• Describe the recent activities surrounding the federal 340B drug discount program

(30 minutes)
Q&A
Cheryl Hetland, MA, 340B ACE; Rachel Pugliano, RHIT, CHC; and Deyon Suchla

Critical Access Hospital and Rural Health Clinics Reimbursement Virtual Symposium -
On-Demand

Speakers

	Sandy Giangreco Brown, RHIT, CHC, CCS, CCS-P, CPC, COC, CPC-I, COBGC, is the director of coding and revenue integrity at CliftonLarsonAllen LLP. (CLA) She is an AHIMA-approved ICD-10-CM trainer specializing in physician practices and outpatient hospitals and also has experience in the HIM, chargemaster, and the inpatient hospital side of business. She previously supervised staff who audited and educated providers at a large payor/healthcare practice in Colorado. She has more than 33 years of experience in healthcare and medical records management, coding, auditing and compliance in the hospital, outpatient and physician settings. She continues to do both regional and national presentations for groups such as AHIMA, HCCA, and the AAPC, as well as others.
	Darice Grzybowski, MA, RHIA, FAHIMA, is president of H.I.Mentors, a best practice health information, revenue cycle, software and strategic marketing consulting company located in Westchester, Illinois. Darice has more than 30 years of HIM practice and consulting experience and holds a master degree in clinical data management from DePaul University. She is an RHIA, an AHIMA Fellow, and an AHIMA-approved ICD-10-CM/PCS trainer and ambassador. Darice has won multiple awards for her work in HIM, including an AHIMA Triumph Award, and was named one of Advance Magazine’s Top Ten in 2010 HIM Professionals.
	Cheryl Hetland, MA, 340B ACE, PTCB Certified Pharmacy Technician, is a healthcare director in the CliftonLarsonAllen LLP healthcare consulting group. Cheryl specializes in pharmacy operations and business management. She provides compliance, strategy, operations and finance consulting for healthcare providers and government entities. She is 340B Apexus-certified and provides auditing and consulting services to 340B-eligible covered entities. Before joining CliftonLarsonAllen, she provided specialized consulting support to government and public sector healthcare programs implementing pharmacy and managed-care initiatives.
	Joy Krush, RHIT, CCS, CCS-P, CDIP, healthcare consulting senior manager with Eide Bailly LLP, has more than 30 years of experience in the healthcare industry in the mid-cycle of the revenue cycle. Her experience is in hospital coding (inpatient and outpatient), health information management functions, compliance, chargemaster, charge capture, and documentation improvement. Joy has experience in clinical documentation integrity (CDI) working with CDI reviewers and providers to assist with complete and compliant documentation which assures correct reflection of severity of illness. Joy is a member of AHIMA, NDHIMA, NAHRI, HFMA and is currently on the AHIMA Revenue Cycle Management Practice Council.
	Rachel Pugliano, RHIT, CHC, healthcare consulting senior manager with Eide Bailly LLP, has over 20 years of experience focusing on the mid-cycle of the revenue cycle, which would include coding, documentation integrity, and charge capture. Rachel assesses the overall health and capabilities of an organization's revenue cycle functions, develops coding compliance and documentation improvement strategies for both hospitals and medical group practices and provides internal coding compliance and charge capture assistance to improve coding and charge accuracy. Rachel is a member of AHIMA, HCCA, and is on the board for the South Texas HFMA chapter serving as programs chair.
	Joe Rivet, Esq., CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO, is an adjunct instructor for HCPro’s Medicare Boot Camp®—Hospital Version, Utilization Review Version, Critical Access Hospital Version, and Rural Health Clinic Version. In addition, he is a practicing attorney with a focus on healthcare reimbursement. Rivet has over 20 years of experience in healthcare operations. Before he became an attorney, he worked in numerous healthcare settings, including community hospitals, large medical groups, and one of the nation’s largest integrated delivery systems. Additionally, he has served as a compliance and privacy officer for a factuality practice and large emergency medical services billing and coding company. Rivet is a frequent expert speaker on HCPro’s webinars and has spoken at national conferences on reimbursement topics.
	Susan Rohde, RHIT, CCS-P, CPC, healthcare consulting senior manager with Eide Bailly LLP, has more than 25 years of health care experience with an emphasis on professional coding. She specializes in interventional radiology coding, surgical coding, and coding for both inpatient hospital and outpatient clinic accounts. Susan also provides proper evaluation and management (E/M) codes to obtain accurate reimbursement, with a focus on the new 2021 E/M Guidelines.
	Deyon Suchla, healthcare consulting senior manager with Eide Bailly LLP, has more than 35 years of experience in the industry with the last 20 years focused on management of revenue cycle processes. She provides interim management services, consulting and training consistent with compliance guidelines for Medicare and other third-party payers per hospital and clinic regulations.

Critical Access Hospital and Rural Health Clinics Reimbursement Virtual Symposium -
On-Demand

Learning Objectives

• Discuss Medicare coding and billing requirements that present challenges for CAHs in 2021
• Identify the different types of COVID-19 vaccines available and discuss coding and reimbursement.
• Describe coverage and billing requirements for a medical visit and mental health visit
• Describe ways to improve processes for payments and collections
• Determine the roles and responsibilities associated with the upkeep of the CDM, charge capture, coding, billing and revenue integrity functions
• Explain the difference between 1995/1997 E/M and 2021 E/M guidelines
• Explain the importance of documentation
• Describe how medical necessity applies to the new guidelines
• Identify documentation requirements that need to be met to support coding of these diagnosis and procedures for COVID-19 and telehealth
• Determine the value of remote and outsourced staffing models
• Describe the role of CDI in ensuring compliant medical records

Critical Access Hospital and Rural Health Clinics Reimbursement Virtual Symposium -
On-Demand

Continuing Education

AAPC
This program has the prior approval of AAPC for 7 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

Ability to claim credits for this webinar expires on: 4/30/22

ACDIS
This program has been approved for 7 continuing education units towards fulfilling the requirements of the Certified Clinical Documentation Specialist (CCDS) certification and CCDS-O (outpatient) certification, offered as a service of the Association of Clinical Documentation Integrity Specialists (ACDIS).

AHIMA
This program has been approved for 7 continuing education unit(s) 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 credits for this webinar expires on: 4/26/22

NAHRI
This program has been approved for 7 continuing education units towards fulfilling the requirements of the Certification in Healthcare Revenue Integrity (CHRI), offered as a service of the National Association of Healthcare Revenue Integrity (NAHRI).

Ability to claim credits for this webinar expires on: 4/26/22

NASBA
Earn up to 8.4 CPE Credits!
Program Level: Intermediate
Delivery Method: Group Live - Internet

HCPro is registered with the National Association of State Boards of Accountancy (NASBA) as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be submitted to the National Registry of CPE Sponsors through its website: www.nasbaregistry.org.