Revenue Integrity Symposium: A NAHRI Virtual Event

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Revenue Integrity Symposium: A NAHRI Virtual Event

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Revenue Integrity Symposium: A NAHRI Virtual Event

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Revenue Integrity Symposium: A NAHRI Virtual Event

Tuesday August 17 – Wednesday, August 18, 2021 

The 2021 Revenue Integrity Symposium (RIS) is now virtual!

Join us for Revenue Integrity Symposium: A NAHRI Virtual Event, the can’t-miss experience for revenue integrity, revenue cycle, and Medicare compliance education and high-level networking.

Though we were hoping to be together in person for this year’s event, NAHRI and HCPro made the decision to turn 2021 RIS into a 100% virtual experience, allowing all who want to participate to join in the education and networking and earn CEUs.

The event features the great content and industry-leading speakers you have come to expect from RIS, so you can learn from trusted experts with cutting-edge regulatory insight that will arm you with the tools you need to take 2022 by storm!

This is our biggest virtual event yet offering more than a dozen continuing education credits. When you listen live, you can choose sessions from two tracks, but all sessions are available on demand for 60 days after the close of the event, so no need to miss any education!

PLUS, every RIS registration comes with a free seat at two regulatory update webinars this fall so you can ensure you stay up to date with the rules. Dates are still to be announced for these programs, but all RIS registrants will automatically receive the email instructions to join the webinars:

  • 2022 IPPS final rule webinar (Tuesday, September 21)
  • 2022 OPPS final rule webinar (date TBA)


Some of this year’s hot topics include:

  • Maintaining an up-to-date and compliant charge description master and setting policies for charging for procedures and supplies, including self-administered drugs
  • Strategies for designing a revenue integrity program, developing workflows, and setting and meeting revenue integrity goals
  • Best practices for reducing payer denials using targeted data analytics
  • Current payer audit targets and strategies to protect revenue
  • Understanding the impact of patient status and navigating payer regulations
  • Methods to effectively manage I/OCE and NCCI edits


Sessions begin around noon Eastern time or 9 a.m. Pacific time, allowing attendees to come together regardless of their geographic location. There will also be live question and answer sessions with event speakers, a virtual cocktail hour, and live-stream discussion strings enabling attendees to share in the most valuable asset of all—our networking experiences.

After attending this event, learners will be able to:

  • Analyze strategies for ensuring compliance with recent CMS regulations
  • Define best practices for maintaining an up-to-date and compliant chargemaster
  • Utilize the latest information on external auditors and learn new strategies for dealing with claim denials and appeals
  • Demonstrate strategies for accurately documenting, coding, and billing patient encounters and stays


Don’t miss the opportunity to position your team for success at this insightful event!

Discounts are available for group purchases!
Please note that your registration includes log-in access for one attendee. HCPro reserves the right to revoke your access if we find that you are sharing your login or any of the class information. If you would like to purchase multiple seats, please call our sales team at 615-724-7200 or email sales@hcpro.com to discuss discounted rates for bulk purchases.

Revenue Integrity Symposium: A NAHRI Virtual Event

Speakers

Dawn Crump, MA, SSBB, CHC, is senior consultant for revenue cycle solutions with MRO Solutions in Norristown, Pennsylvania. Crump has worked in the hospital environment within quality, compliance, or revenue integrity for the last 20 years. In addition, she managed internal coding compliance and the government audit and denial team for a large health system. Drawing on her strong analytical and relationship-building skills and more than 20 years of urban and rural healthcare experience, she has guided providers to successfully analyze their critical financial information, identify potential opportunities for improvement, and develop innovative cost-effective solutions, enhancing revenue retention and customer satisfaction opportunities. She obtained her Six Sigma Black Belt/Lean certification more than 10 years ago.

David Ferrin, MBA, is the senior consultant at nThrive Analytics. As part of his 20 years of experience in healthcare, his work as a swing-shift registrar and biller in the emergency room led him to learn more about revenue cycle processes and services. As a revenue cycle director for a children’s hospital and then within a large CBO, he became interested in understanding data and how the right metrics can drive change to improve the patient experience both before and after receiving care. 

Sarah L. Goodman, MBA, CHCAF, COC, CCP, FCS, CHRI, is president/CEO and principal consultant for SLG, Inc., in Raleigh, North Carolina. She is a nationally known speaker and author on the chargemaster, outpatient facility coding, and billing compliance, and has more than 30 years’ experience in the healthcare industry. Goodman has been actively involved and held leadership roles in a number of professional organizations on the local, state, and national levels—including NAHRI, where she serves as an advisory board member.

Ronald L. Hirsch, MD, FACP, CHCQM, CHRI, is vice president of R1 RCM in Chicago. Hirsch was the medical director of case management at Sherman Hospital in Elgin, Illinois. He is a member of the American Case Management Association, a member of the American College of Physician Advisors, and a fellow of the American College of Physicians. Hirsch serves as an advisory board member for NAHRI.

Rosemary Holliday, MHA, is a managing partner of Holliday & Associates and one of the industry’s thought leaders in the area of chargemaster management. Holliday’s company has dedicated 30 years to providing consulting, educational, and software solutions to the hospital industry. Her 44-year healthcare background lends expertise to her operational knowledge of the many technical, clinical, and support areas of today's healthcare environment. 

Kurt Hopfensperger, MD, JD, is vice president, compliance and physician education, at Optum Physician Advisor Solutions, a national organization that provides technology-enabled, expert physician advisor teams concentrating on managing Medicare and Medicaid regulatory compliance, minimizing inappropriate medical necessity denials, and achieving appropriate lengths of stay in acute care hospitals and health systems. Previously, Hopfensperger developed an accomplished career as a 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. He 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.

Kimberly A. Hoy, JD, CPC, is the director of Medicare and compliance for HCPro. She is a lead regulatory specialist and lead instructor for HCPro’s Medicare Boot Camp®—Hospital Version and Medicare Boot Camp—Utilization Review Version. She is also an instructor for HCPro’s Medicare Boot Camp—Critical Access Hospital Version. Hoy is a former hospital compliance officer and in-house legal counsel, and has 10 years of experience teaching, speaking, and writing about Medicare coverage, payment, and coding regulations and requirements.

Kay Larsen, BS, CRCR, is a revenue integrity specialist at Glendale Adventist Medical Center (soon to be Adventist Health Glendale) in California. She has enjoyed 17 years working in healthcare, including many years as a chargemaster coordinator. Larsen’s favorite part of her job is working with departments to maximize revenue through education and charge review. In her years of work, she has experienced standardization projects, extensive price reviews, and conversion of financial systems and is still passionate about revenue integrity. Larsen serves as an advisory board member for NAHRI.

William L. Malm, ND, RN, CMAS, CRCR, CHIAP, is a nationally known author and speaker with more than 25 years of experience in clinical and financial healthcare. As vice president of Health Catalyst, Malm specializes in chargemasters, audit and compliance, and charge capture. In previous compliance and revenue integrity work at for-profit and not-for-profit healthcare systems, he managed and conducted hundreds of pre-pay and post-pay audits. Malm is past president of the Certification Council for Medical Audit Specialists. He was elected the 2014 Medical Audit Specialist of the Year and is active in the Healthcare Financial Management Association and the Association of Healthcare Internal Auditors.

Linda J. McCray, CPA, MBA, started her accounting career in a small public accounting firm in northwest Washington. She began her journey in healthcare as an internal auditor for Adventist Health. She worked in several positions during her career with Adventist Health, such as director of fiscal services, CFO, and regional CFO. Since retirement, she has consulted with hospitals working to improve charge capture in electronic medical records.

Jerilyn Morrissey, MD, is senior vice president, clinical and regulatory affairs at Versalus Health. She is responsible for regulatory, private payer, and utilization management education for case management staff and physicians. Morrissey is passionate about using data and technology to help hospitals navigate complex Medicare regulations and understand payer practices and their impact on the hospital revenue cycle. Morrissey’s experience as a practicing physician, a physician advisor for a nationally recognized health system, and a director of clinical information for a national payer afford her a unique perspective to solve utilization management’s evolving challenges.

Johnny Pezzuto is vice president, revenue integrity program at R1 RCM. With more than a decade of revenue integrity experience, he has served as R1’s senior director of revenue cycle services for the past four years before recently taking on a larger role as Vice President. He directs revenue integrity programs that total over $30 billion in NPR for a variety of provider clients, leading a team that has helped clients drive more than $100 million additional cash lift. Prior to joining R1, he held revenue integrity manager and analyst positions at Ascension Health and Alexian Brothers Health System. He is a frequent presenter and author on topics that help providers stop leakage and increase reimbursement through revenue integrity, and most recently wrote “4 Must-Haves of a Revenue Integrity Solution” for HIT Consultant. Pezzuto holds an MBA and BA in finance from Dominican University.

Valerie Rinkle, MPA, CHRI, is president of Valorize Consulting and has more than 35 years’ experience in healthcare policy, finance, strategy, and revenue management operations. Her expertise spans all CMS reimbursement methodologies and the operational capabilities necessary to effectively achieve accurate and defensible payment. She has extensive hospital chargemaster, OPPS and physician fee schedule, and provider-based department experience. Rinkle also has significant experience in leading compliance due diligence in support of M&A as well as defense strategies surrounding OIG, DOJ, RAC, and other audit agencies including state Medicaid programs. She has served as an expert witness in litigation. She works with device manufacturer and pharmaceutical manufacturers for their coding and reimbursement support. Rinkle is a frequent public speaker with HCPro and as an annual presenter on OPPS at the Institute on Medicare and Medicaid Payment Policy by the American Health Lawyers Association where she co-presents with CMS representatives.

Joe Rivet, Esq., CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO, is a regulatory specialist for HCPro. He is the lead instructor for the Revenue Integrity and Chargemaster Boot Camp®. Rivet also instructs the Medicare Boot Camp®—Hospital Version, Critical Access Hospital Version, and Rural Health Clinic Version. He is an expert speaker on HCPro’s webinars and at national conferences on reimbursement topics. In addition, he is a practicing attorney with a focus on healthcare reimbursement and more than 20 years of experience in healthcare operations. Previously, Rivet worked in community hospitals, large medical groups, and one of the nation’s largest integrated delivery systems. Additionally, he was a compliance and privacy officer for a factuality practice and large emergency medical services billing and coding company.

John Settlemyer, MBA, MHA, CPC, CHRI, is an assistant vice president, revenue cycle, with Atrium Health (formerly Carolinas HealthCare System) based in Charlotte, North Carolina. Atrium Health is one of the most comprehensive public, not-for-profit systems in the nation. Settlemyer has 25 years’ experience in healthcare finance/reimbursement and has been with Atrium Health for more than 15 years, with focus in chargemaster compliance, charge capture, and revenue integrity. He has direct or consulting oversight of the chargemaster for 40 hospitals and their associated outpatient care locations, such as provider-based clinics, healthcare pavilions, and freestanding emergency departments. He is a charter member and inaugural chair (serving two terms) of The Provider Roundtable, a national group of volunteer providers whose focus is providing comment to CMS on the operational and financial impact of OPPS proposed rules. In addition, he is an adjunct instructor for HCPro’s Revenue Integrity and Chargemaster Boot Camp and is an Advisory Board member for NAHRI.

Jugna Shah, MPH, CHRI, is the president and founder of Nimitt Consulting, Inc., a firm specializing in case-mix payment system design, development, and implementation. She has 15 years of experience working with providers on the ongoing clinical, operational, financial, and compliance implications of Medicare’s OPPS based on APCs. Shah has educated and audited numerous hospitals on their drug administration coding and billing practices. She has contributed to several books and numerous OPPS/APC articles and is a contributing editor of HCPro’s Briefings on APCs. Shah serves as an advisory board member for NAHRI.

Angela Lynne Simmons, CPA, is the vice president of revenue and reimbursement at Vanderbilt University Medical Center. A Texas CPA, she brings more than 30 years of experience in healthcare operations and finance, and public accounting for healthcare entities. Simmons has expertise in healthcare policy, reimbursement principles from government programs (Medicare and Medicaid), as well as healthcare financial analysis and cost accounting. Much of her focus throughout her career has been on pursing revenue opportunities through improving hospital operations and through Medicare filings and appeals. Prior to relocating to Vanderbilt, she was the director of clinical revenue and reimbursement for U.T. M.D. Anderson Cancer Center, where she was responsible for Medicare and Medicaid reimbursement, cost accounting, revenue and rate-setting, financial analysis, and clinical decision support reporting.

Angela Sorbelli, J.D., LL.M, MBA, CHC, is a consummate compliance professional with more than 15 years of experience assisting hospitals and health systems navigate the complexities of regulations and compliance. At Versalus Heath, Sorbelli leads the operational response to regulatory and appeals issues. Prior to joining Versalus, Sorbelli served as a director of healthcare compliance for a CMS-contracted Recovery Auditor and as a director of regulatory affairs at a large health care solutions company. In both organizations, she had oversight of compliance and regulatory curriculum, and has a proven track record of identifying areas of compliance vulnerability and risk and implementing successful corrective action plans.

Andrew Stieve is vice president, revenue integrity for R1 RCM, where he is responsible for leadership, oversight, and strategic direction of revenue integrity solutions. He has more than a decade of revenue cycle leadership experience for healthcare providers, and prior to R1, led his team to generate an additional $15 million in net revenue in just four years while serving as Ascension’s director of the national revenue integrity team. He has also held various management roles for the revenue cycle team at Alexian Brothers Health System and is an experienced leader in charge structure redesign, chargemaster review and management, price rationalization and forecasting, payer contracting, strategic pricing, compliance, and denials management. He is a frequent speaker and author on revenue integrity and recently wrote “Maximizing Post-COVID Reimbursement with Revenue Integrity” and “Optimizing Revenue Integrity Initiatives with a Focus on Payer Contracts.” Stieve holds a Bachelor of Business Administration from University of Wisconsin-Whitewater. 

Varadarajan Subbiah, MD, MBA, FACP, CHCQM, is the vice president of utilization management and quality at ChristianaCare in Newark, Delaware. He has practiced internal medicine for over 10 years and has served as senior physician advisor, medical director of observation care, and medical director of patient access and flow. He has worked at multiple hospitals in the Greater Philadelphia area and is a frequent speaker on the topics of observation care, utilization management, and discharge planning. Dr. Subbiah completed his medical degree at Rutgers New Jersey Medical School and an internal medicine residency at Temple University Hospital. He further completed a master’s degree in business administration from the University of Massachusetts at Amherst. He is a diplomate of the American Board of Internal Medicine and a fellow of the American College of Physicians. He also has a physician advisor sub-specialty certification from the American Board of Quality Assurance and Utilization Review Physicians.

Denise Williams, COC, CHRI, is senior vice president of the revenue integrity division and compliance auditor at Revant Solutions, Inc. She has more than 30 years of healthcare experience, including a background in multiple areas of nursing. For the past 25 years, Williams has been in the field of coding and reimbursement and has performed numerous E/M, OP surgical, ED, and observation coding chart reviews from the documentation, compliance, and reimbursement perspectives. She serves as a contributing author to articles published in HCPro’s Briefings on APCs and is a nationally recognized speaker on various coding and reimbursement topics. Williams serves as an advisory board member for NAHRI.

Joseph Zebrowitz, MD, is founder/president of Versalus Health, a company providing hospitals with next-generation analytic and operational solutions focused on the intersection of utilization management, revenue cycle, and compliance. Previously, Zebrowitz served as executive vice president for Executive Health Resources, where he was a trusted advisor to thousands of hospitals and established the standard for medical necessity reviews. He has focused his career on helping hospitals gain an accurate picture of their compliance and revenue integrity. He is a NAHRI Advisory Board member.

Revenue Integrity Symposium: A NAHRI Virtual Event

Agenda


Day 1 — Tuesday, August 17, 2021

12:00 p.m. – 12:45 p.m. 
Track 1: Four Key Components to Revenue Integrity Success
Andrew Stieve and Johnny Pezzuto

Revenue leakage costs hospitals 1%–3% of revenue annually, and this figure has likely increased in the past year. In addition to new codes and changing regulations, revenue cycle management teams face tighter margins, furloughs and layoffs, and evolving work environments. This presentation will cover four components that serve as a foundation for successful revenue integrity programs in the post-COVID-19 world—helping to maximize reimbursement, ensure a streamlined workflow, and close ever-present gaps among revenue integrity analysts, billers, coders, and clinicians. Attendees will learn how to develop a comprehensive revenue integrity program that includes strategies for minimizing leakage, optimizing reimbursement, identifying COVID-19 revenue opportunities, and mitigating risk from compliance violations and external audits. The presentation will outline case studies with practical applications, offering tactics that have yielded significant ROI for hospitals and health systems.

12:00 p.m. – 12:45 p.m. 
Track 2: The CDM: Tales From a CFO, Coordinator, Consultant, and Vendor
Sarah L. Goodman, MBA, CHCAF, COC, CCP, FCS, CHRI; Rosemary Holliday, MHA; Kay Larsen, BS, CRCR; and Linda J. McCray, CPA, MBA

Get an inside look at best-practice strategies for maintaining an up-to-date and accurate charge description master (CDM) and promoting collaboration among CDM professionals, financial leadership, and consulting experts. This panel session will use case studies and real-life examples to explain the role of the CDM coordinator, CFO, and outside consultants and vendors. Attendees will take away key tips for promoting revenue integrity in the facility setting. 

12:55 p.m. – 1:40 p.m. 
Track 1: In the Trenches With the Chargemaster and Facility Charge Capture
Sarah L. Goodman, MBA, CHCAF, COC, CCP, FCS, CHRI; and Kay Larsen, BS, CRCR

Gain a better understanding of the structure of a CDM and common reimbursement methodologies. This session will offer tips for maintaining an up‐to‐date and compliant CDM, provide guidance on identifying charge capture strategies for typical ancillary services, and describe best-practice methods for managing COVID-19 changes related to the chargemaster.

12:55 p.m. – 1:40 p.m. 
Track 2: Defensible Patient Status: Leveraging AI to Adapt to Payer and Regulatory Medical Necessity Developments
Kurt Hopfensperger, MD, JD

Medical necessity now accounts for 20% of all denials—a 66% increase over two years—and commercial payer appeal success has dropped to 45%. At the same time, regulatory pressure is increasing. This changing payer landscape has made effective utilization review more important than ever. Defensible patient status determinations can help prevent denials and raise the chances of successful appeals. During this session, Dr. Kurt Hopfensperger will discuss patterns in payer behavior, the consequences of regulatory changes, and how artificial intelligence (AI) can help hospitals keep ahead of these trends to maintain their revenue integrity.

1:50 p.m. – 2:20 p.m. 
Developing a Targeted HCC Management Process; A Patient-centric Approach
Sponsored by: 3M Health Systems

2:20 p.m. – 2:40 p.m. 
NETWORKING BREAK

2:40 p.m. – 3:25 p.m. 
Track 1: Halting the Elimination of the Inpatient-Only List: Proposed OPPS CY 2022
Jerilyn Morrissey, MD, Angela Sorbelli, J.D., LL.M, MBA, CHC, and Joseph R. Zebrowitz, MD

With the recent release of the anticipated CY 2022 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Proposed Rule (CMS-1753-P), CMS is reverting to its previous approach on the inpatient-only list. Join this session to learn about the proposed rule, understand the implications of this reversal, and the proposed changes to medical review audits.

2:40 p.m. – 3:25 p.m. 
Track 2: Effective Management of Commercial and Medicare Advantage Denials
Varadarajan Subbiah, MD, MBA, FACP, CHCQM

Authorization and claims denials are one of the largest threats to revenue integrity. Hospitals must present a coordinated response and utilize all available tools to effectively combat denials. This session will cover how to monitor key performance indicators, establish a peer-to-peer process, coordinate and track denials, and highlight opportunities to improve communication among hospital departments including utilization management, case management, patient financial services, and contracting.

3:35 p.m. – 4:20 p.m.
Track 1: Revenue Integrity and Your Medical Staff: Updates, Controversies, Keys to Success
Ronald Hirsch, MD, FACP, CHCQM, CHRI; Kay Larsen, BS, CRCR; and Joseph Zebrowitz, MD

Whether they realize it or not, hospital medical staff play a crucial role in revenue integrity. They hold the power in their pen and keyboard. Yet, no physician ever went into medicine with the goal of understanding the regulatory history of the 2-midnight rule, dissecting the inpatient-only list, delivering patient notices, or ensuring that hospital claims are submitted accurately. In this session, a veteran revenue integrity leader will moderate a discussion with two leading physicians in the regulatory realm to discuss keys to working with physicians to ensure compliance with regulations and documentation, touching on issues such as the compliant use of observation, the admission order, the 2-midnight presumption, medical necessity, and more.

3:35 p.m. – 4:20 p.m.
Track 2: NCCI Edits in Depth: Make Them a Resource Instead of an Obstacle
Joe Rivet, Esq., CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO

This session will review the three types of NCCI edits: procedure-to-procedure edits, Medically Unlikely Edits, and add-on code edits. Learn how to find resource tables and manuals to research your edit and modifier questions. Understand appropriate use of modifiers for procedure-to-procedure edits. Medically Unlikely Edit rationale and applicability of add-on code edits will also be discussed. 

4:30 p.m. – 5:00 p.m. 
Join the speakers for a live Q&A and submit all your questions from the day’s sessions.

Sarah L. Goodman, MBA, CHCAF, COC, CCP, FCS, CHRI; Ronald Hirsch, MD, FACP, CHCQM, CHRI; Rosemary Holliday, MHA; Kay Larsen, BS, CRCR, ; Linda J. McCray, CPA, MBA; Jerilyn Morrissey, MD; Joe Rivet, Esq., CCS-P, CPC, CEMC, CHC, CCEP, CHRC, CHPC, CICA, CPMA, CAC, CACO; Andrew Stieve; Varadarajan Subbiah, MD, MBA, FACP, CHCQM; and Joseph Zebrowitz, MD


Day 2 — Wednesday, August 18, 2021

12:00 p.m. – 12:45 p.m. 
Track 1: CDM Guru: What Would You Do?
John D. Settlemyer, MBA, MHA, CPC, CHRI; Angela Lynne Simmons, CPA; Valerie Rinkle, MPA, CHRI; and Denise Williams, COC, CHRI

CDM operations are often fraught with difficult dilemmas that are not easily resolved. Join our CDM experts in this roundtable-style discussion, where they’ll discuss complex or troublesome CDM charging and billing issues along with options for resolution. Listeners are encouraged to ask questions of the panel during this interactive session.

12:00 p.m. – 12:45 p.m.
Track 2: Reducing Denials Using Targeted Data Analytics and Best Practices
David Ferrin MBA

This session will focus on identifying strong tools to manage denials and analyze trends. Topics will include understanding denial codes, using automated technology to flag denials, and reporting on denial trends. The session will also provide best practices in setting denial KPIs and creating standard metrics. Participants will learn how to utilize data, how to implement a denials program, and how to address the issues that most commonly arise, all through real-life examples.

12:55 p.m. – 1:40 p.m. 
Track 1: The Myth of Inpatient Level of Care for Medicare Patients
Kimberly A. Hoy, JD, CPC

Misunderstandings abound regarding an inpatient level of care and the role of outpatient services, including observation, in the 2-midnight rule. Yet CMS has been clear from the beginning and continues to be clear about these issues. Through quotes from CMS, this session will provide you CMS’ real guidance and an understanding of what it means for inpatient admissions. Face auditors with CMS’ own words and guidance to defend care that is appropriate for payment under Part A. 

12:55 p.m. – 1:40 p.m. 
Track 2: How to Effectively Comply With Payer Integrity Audits
Dawn Crump, MA, SSBB, CHC

The reprieve is over. All payers have resumed payment integrity audits in 2021. While these audits are useful to ensure compliance and proper reimbursement, they don’t always go smoothly. Early COVID-19 claims are also being reviewed and will have a significant impact on the large-dollar, aged accounts. With a deluge of audits ahead, this session will help attendees properly prepare their people, processes, and technology. The speaker will share proven strategies and tactics to quickly streamline Medicare and commercial payer integrity audits, reduce labor costs, and realize a higher return for the organization’s efforts.

1:50 p.m. – 2:20 p.m. 
SPONSORED LIGHTNING ROUND

2:20 p.m. – 2:40 p.m. 
NETWORKING BREAK

2:40 p.m. – 3:25 p.m. 
Track 1: Overview of Self-Administered Medications in 2021
William L. Malm, ND, RN, CRCR, CMAS, CHIAP

This session will provide an overview of an operationally hard concept to implement for chargemaster, revenue integrity, and, ultimately, the patients: self-administered medications. Let’s go back in history and show the concepts, current source authority, and OIG guidance, then provide some plans for success.

2:40 p.m. – 3:25 p.m.
Track 2: Effective Application of the I/OCE
Kimberly A. Hoy, JD, CPC

Learn how to use the Medicare quarterly resources to keep your chargemaster updated throughout the year. This session will demonstrate downloading the I/OCE and how to use the included resources to update your chargemaster and billing edits to ensure smoother quarterly transitions to new codes and edits. Proactively prepare for changes instead of reacting to RTPs and denials. 

3:35 p.m. – 4:20 p.m. 
Track 1: Best Practice Charge Capture Methods for Your Emergency Department
William L. Malm, ND, RN, CRCR, CMAS, CHIAP

Facilities must ensure the basics and requirements of E/M, surgical coding, supplies, and pharmacy are appropriately captured to match facility resources to their charges. This session will cover high-failure areas, such as point systems, and demonstrate methods for optimization.

3:35 p.m. – 4:20 p.m. 
Track 2: In Plain Sight: CMS’ Policies to Influence Site of Care
Valerie Rinkle, MPA, CHRI; and Jugna Shah, MPH, CHRI 

A number of CMS coverage and payment policies are designed to influence site of service, including changes to the inpatient-only list, prior authorization, the ASC procedure list, and payments for high-cost therapies. This session will review which site-of-service options are valid for certain services and discuss likely reactions and impacts of these policies within the healthcare marketplace.

4:30 p.m. – 5:00 p.m.
Join the speakers for a live Q&A and submit all your questions from the day’s sessions.

Dawn Crump, MA, SSBB, CHC; David Ferrin MBA, Kimberly A. Hoy, JD, CPC; William L. Malm, ND, RN, CRCR, CMAS, CHIAP; Valerie Rinkle, MPA, CHRI; John D. Settlemyer, MBA, MHA, CPC, CHRI; Jugna Shah, MPH, CHRI; Angela Lynne Simmons, CPA; and Denise Williams, COC, CHRI


— Agenda subject to change —

Revenue Integrity Symposium: A NAHRI Virtual Event

Continuing Education

The continuing education credits listed are available for live attendees only. Participants can claim credit for the live sessions they attend from either track August 17–18. As a bonus, attendees will also be able to watch recordings of sessions they were not able to attend live, although CE credits will not be available for on-demand sessions.

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.

ACDIS (CCDS and CCDS-O)
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 units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).

ANCC
This program has been approved for 7 continuing education units for use in fulfilling the continuing education requirements of the American Nurses Credentialing Center’s Commission on Accreditation (ANCC). 

CCB
The Compliance Certification Board (CCB) has approved this event for up to 8.4 CCB CEUs. Continuing Education Units are awarded based on individual attendance records. Granting of prior approval in no way constitutes endorsement by CCB of this program content or of the program sponsor.

CCMC
This program has been pre-approved by the Commission for Case Manager Certification to provide continuing education credit to CCM board certified case managers. The course is approved for 7 CE contact hours.

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).

Revenue Integrity Symposium: A NAHRI Virtual Event

Sponsors

Platinum:
3M

Silver:
Hayes     Vitalware

Exhibitors:
ChargeAssist
Streamline Health

Sponsorship opportunities are available for the 2021 Revenue Integrity Symposium! For more information contact Carrie Dry, National Sales Manager, 630-235-2745 or cdry@hcpro.com.