2023 Revenue Integrity Symposium

Monday, September 18 – Tuesday, September 19, 2023

The Revenue Integrity Symposium is the premier event for revenue integrity, revenue cycle, and Medicare compliance education and high-level networking. Learn from trusted experts with cutting-edge insight that will empower you to ensure compliance with regulatory changes, maximize revenue, and enhance workflow and program design. Presented by the National Association of Healthcare Revenue Integrity (NAHRI), the Revenue Integrity Symposium is the first conference to look at critical hospital reimbursement and compliance issues through the lens of revenue integrity.

We can’t wait to connect at the Sheraton Charlotte Hotel in beautiful Charlotte, North Carolina, from September 18–19, 2023.

The Revenue Integrity Symposium provides countless opportunities to engage personally and professionally with like-minded individuals across the healthcare spectrum. We’re offering unmatched educational opportunities from industry experts and the chance to build meaningful connections with your peers through extensive networking. So, bring your best practices, your curiosity, and your drive to learn—and help us make 2023 the best year yet!

Highlights for 2023

• The 2023 conference brings you top-notch speakers across two tracks, providing opportunities for all in revenue cycle, revenue integrity, and compliance
• You’ll gain expert insight and tips for:
  • Avoiding and managing payer denials
  • Maintaining your chargemaster
  • Addressing charging and charge capture issues
  • Resolving claims edits
  • Creating effective workflow and program structures
  • Ensuring compliance with the latest rules
• You’ll also get access to an app that includes all session materials, a session planner, and unparalleled networking with your peers
• As always, the Revenue Integrity Symposium provides continental breakfast, lunch, and networking breaks with snacks and beverages, plus a networking reception—all included with registration

2023 Revenue Integrity Symposium

Who Should Attend

• Revenue integrity professionals
• Revenue cycle directors and staff
• Compliance officers
• CFOs, CMOs, CNOs, and VPMAs
• Case managers
• HIM directors, managers, and staff
• Utilization review and utilization management coordinators, committee members, and physician advisors
• Recovery audit coordinators and other auditing professionals
• Reimbursement managers, billers, and other finance staff
• Chargemaster coordinators
• Business office managers and staff
• Risk management professionals
• Patient financial services managers
• Clinical documentation integrity specialists
• Coders and coding managers

2023 Revenue Integrity Symposium

Agenda

Day 1 — Monday, September 18, 2023

7:00 a.m. – 8:00 a.m.
Registration and Continental Breakfast in the Exhibit Hall

8:00 a.m. – 9:00 a.m.
Keynote Session
Getting Your Voice Heard
Larry O’Brien

9:10 a.m. – 10:10 a.m.
Breakout Sessions 1

Breakout Session 1.1
2024 OPPS, MPFS, and IPPS: Analyzing the Latest Final and Proposed Changes
Marc Hartstein, John D. Settlemyer, MBA, MHA, CHRI, and Jugna Shah, MPH, CHRI

Learn all you need to know about the latest finalized IPPS changes for FY 2024 and the major proposed changes for OPPS and MPFS for CY 2024. Ensure your hospital is prepared from a reimbursement and compliance perspective!

Breakout Session 1.2
Advanced Analytics for Revenue Integrity
Rochell Dahmen, CSBI

The future economy is all about data, so make sure your data is working for you! The information that can be found from analyzing data trends can help your health system determine where you might be vulnerable or where risks may be hidden. Utilizing data analytics in conjunction with compliance and internal audit gives your organization a point-in-time response where analytics layers with ongoing monitoring to help mitigate your exposure to risk and improve operational efficiency. 

10:10 a.m. – 10:40 a.m.
Networking and Refreshment Break in the Exhibit Hall

10:40 a.m. – 11:40 a.m.
Breakout Sessions 2

Breakout Session 2.1
Adding Clarity and Value to the CDM
Sarah Goodman, MBA, CHCAF, COC, CHRI, CCP, FCS; Rosemary Holliday; Kay Larsen, CHRI, Linda McCray

How can you add value and clarity to your charge description master (CDM)? What resources should you use? Get an inside look at best-practice strategies for maintaining an up-to-date and accurate CDM and promoting collaboration among CDM professionals, financial leadership, and external 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 addressing CDM challenges and for promoting revenue integrity in the facility setting.

Breakout Session 2.2
Successful Proactive Denials Management: Inviting CDI to the Table
Laurie Prescott, RN, MSN, CCDS, CCDS-O, CDIP, CRC

The efforts of clinical documentation integrity (CDI) are focused on capturing strong documentation. Record reviews are performed concurrently while the patient is present, with the goal of capturing needed documentation prior to discharge. These efforts focus on DRG assignment, accurate capture of principal diagnosis, diagnosis capture and clinical validation. CDI professionals are becoming increasingly involved in denials management as strong documentation is required in this effort. Despite this fact, many organizations still have not invited CDI to the table. Information is key to success and concurrent CDI reviews focused upon known vulnerable encounters or diagnoses should positively impact your denial rates.  The goal should be to prevent the denial BEFORE it occurs, saving time and resources spent in the ongoing battle of denials. This presentation will highlight how to incorporate CD department efforts in your denials management plan. 

11:40 a.m. – 12:40 p.m.
Networking Lunch in the Exhibit Hall

12:40 p.m. – 1:10 p.m.
Sponsored Session

1:20 p.m. – 2:20 p.m.
Breakout Sessions 3

Breakout Session 3.1
A Story of Revenue Integrity Transformation
Heather Davidson, MBA, CCS; Lydia C. Walker, MBA, CPC; Lauren Winn, MBA

This session will explain how UC San Diego Health transformed their revenue integrity to achieve higher staff engagement, stronger relationships with clinical departments, more efficient processes, and improved charge reconciliation. This session will discuss revenue integrity structures, calculating return on investment and scope of work, strategies to support clinical departments, using qualitative and quantitative measures for success, and more.

Breakout Session 3.2
*Info Coming Soon!

2:20 p.m. – 2:50 p.m.
Networking and Refreshment Break in the Exhibit Hall

2:50 p.m. – 3:50 p.m.
Breakout Sessions 4

Breakout Session 4.1
Coding, Billing and Payment Implications of Patient Status, Observation Services, and the 3-Day Payment Window
Ronald Hirsch, MD, FACP, CHCQM, CHRI; Jugna Shah, MPH, CHRI; Valerie Rinkle, MPA, CHRI

Patient status has a ripple effect on billing, coding, and reimbursement but misconceptions about how its defined and how it interacts with observation and other services, the 3-day payment window, and C-APC assignment are common. This session will dispel common misconceptions about billing, coding, documentation, and reimbursement related to patient status. It will also address questions defining the 3-day payment window and explain when and how observation may be ordered and the criteria for payment under the IPPS vs. the OPPS. Clinical scenarios will be used to help illustrate how these concepts are applied in real life situations.

Breakout Session 4.2
A Day in the Life of a Revenue Integrity Professional
Aleah B. Martagon, RHIA, CRCL, and Rachel Pugliano, CHC, RHIT, CRCR

Regardless of size, all organizations face similar challenges when it comes to things like facility charging, charge capture workflows, and split billing, just to name a few. In this session we'll cover these challenges and share solutions that we have found useful. It will also cover how compliance has been integral to the resolution process within revenue integrity.

4:00 p.m. – 5:00 p.m.
Breakout Sessions 5

Breakout Session 5.1
Defense Strategies for Commercial Payer Line Item Charge Denials
Valerie Rinkle, MPA, CHRI, and Glenn Solomon, JD

Commercial payer charge denials can be complex and confusing to unravel and appeal. In this session, learn how typical contract language in commercial payer contracts obligates payers to follow both HIPAA and Medicare requirements for charges. The session will discuss examples of how provider organizations have successfully used arbitration or litigation to overturn line item charge denials. Attendees will leave with a better understanding of the criteria to evaluate whether this approach should be used for payers that deny common hospital charges for point of care lab tests, IV solutions, and bedside procedures.

Breakout Session 5.2
Leveraging RCM and Coding to Help Address the Health Equity Gap
Leigh Poland, RHIA, CCS

The events of the past few years have thrust health equity into the spotlight as providers, regulatory agencies, and payers seek ways to effectively identify and close areas of weakness to achieve care parity across race and ethnicity, gender, sexual orientation, socioeconomic status, and other factors. It is a trend further impacted by the emergence of new quality-based care models that go beyond those established under the Patient Protection and Affordable Care Act of 2010, including Hospital Value-based Purchasing (HVBP), The Hospital Acquired Conditions Reduction Program (HACRP), and the Hospital Readmissions Reduction Program (HRRP). However, many provider organizations struggle to expand their view of health equity and social determinants of health (SDoH) to fully grasp their true reach. Although health equity and SDoH are commonly seen as patient experience and patient relations issues, that view fails to consider how actionable data comes through as a natural occurrence of a patient’s interaction with the health system staff and care team and misses opportunities in coding and revenue cycle management (RCM). In this session, we will walk through steps on how RCM and coding plays an important role in helping to address the health equity gap.

5:00 p.m. – 6:30 p.m.
Networking & Exhibits Reception

6:30 p.m.
Day 1 Concludes

Day 2 — Tuesday, September 19, 2023

7:00 a.m. – 8:00 a.m.
Continental Breakfast in the Exhibit Hall

8:00 a.m. – 9:00 a.m.
Breakout Sessions 6

Breakout Session 6.1
Healthcare Evolution: Revenue Protection in an Era of Uncertainty
Jonathan Wiik, MSHA, MBA, CHFP

Payment uncertainty in the U.S. healthcare system has become an exhaustive burden for all stakeholders—further amplified by COVID-19. Healthcare costs and inconsistent volumes demand a holistic, long-term strategy for financial viability. At the same time, legislative reform and regulatory attempts to address shortfalls in quality, cost, and outcome have stalled, perpetuating inefficiencies and burdensome rules that add expenses instead of removing them. This session will offer effective strategies to help healthcare providers protect their earned revenue and empower frictionless, positive patient experiences.

Breakout Session 6.2
Implementing a multi-disciplinary approach to managing transfers at a tertiary care center
Kristin A. McKee, RN, and Anuja Mohla, DO, MBA, CHCQM-PHYADV

Stewardship of tertiary resources is essential for revenue integrity and patient throughput. Transfers from outside facilities can present a unique challenge to the revenue cycle. Collaboration with a hospital transfer center, compliance, legal, medical staff, case management, and finance departments is critical to developing an efficient workflow for transfers in and out of tertiary care centers. Effective management of interfacility transfers is a multi-step process that requires collaboration from internal and external stakeholders to ensure a community’s tertiary resources are available when needed. In this session, learn how ChristianaCare developed a multi-disciplinary approach to interfacility transfers centered on identifying patient needs and resources uses. Collaboration with patients, utilization management, and other departments, and including a route to escalate to the C-suite. 

9:10 a.m. – 10:10 a.m.
Breakout Sessions 7

Breakout Session 7.1
How Incorrect or Incomplete Authorizations Create Denials and What Carilion Clinic CVI Did to Address Them
Terresa Odum, MBA, CPC, CCS, PMP

In this session, learn how Carillion Clinic reduced authorization denials in its Cardiovascular Institute, modified the structure of its revenue integrity program, and tracked success. The session will discuss the process for developing and staffing a new dedicated position, how the revenue integrity program is structured, and what metrics are used to monitor the value of the new position and processes.

Breakout Session 7.2
*Info Coming Soon! 

10:10 a.m. – 10:40 a.m.
Networking and Refreshment Break in the Exhibit Hall

10:40 a.m. – 11:40 a.m.
Breakout Sessions 8

Breakout Session 8.1
Financial Impact of January 2023 Evaluation and Management update
Sherry Goyal, MD, MBA, CHRI, CRCS, CPC, Epic Resolute Hospital Charging Administration Certified

The January 2023 evaluation and management (E/M) update aimed to decrease provider documentation workload and increase patient satisfaction. However, inappropriate planning and implementation can create reworks for coding and billing staff, shifting rather than eliminating workloads and pressure on the entire system. Organization may also see an increase in claim edits and accounts receivable as many of these accounts may get stuck in claim edit work queues. This presentation will provide information and education regarding streamlining provider education related to future updates and decrease opportunity cost related to reworks.

Breakout Session 8.2
Managing Contemporary Payer Audits
Sandy Giangreco Brown, MHA, BS, RHIT, CCS, CCS-P, CHC, CPC, COC, CPC-I, COBGC, PCS, and Diane Weiss, CPC, CPB, CHRI

In this session we will present an update on all of the current audit activity not only from government and commercial payers. We’ll discuss what to do when notified of an audit, who should be involved in the entire audit management process, how to best prepare the most complete and appropriate response, and how to best utilize the offered or included education. This session will also include best practices for appealing audit results when there might be unfavorable findings as well developing educational opportunities and possible process improvements.

11:40 a.m. – 12:50 p.m.
Networking Lunch—Exhibit Hall Finale

12:50 p.m. – 1:50 p.m.
Breakout Sessions 9

Breakout Session 9.1
Compliance & Revenue Integrity: A Complimentary Relationship
Rachel Pugliano, CHC, RHIT, CRCR

Healthcare organizations are pulled in many different directions, all of which are important from an operations perspective as well as a risk management perspective. How do you determine what takes top priority? It's well-known that revenue integrity is a vital function in any healthcare organization. While compliance brings an independent and objective eye to assess and reduce risk. How can we be certain that revenue integrity is functioning at its best while also utilizing the value that compliance offers? But it shouldn’t be a competition. In this session we will share how one organization's compliance workplan assisted the revenue integrity team as well as revenue producing departments to address risks, identify opportunities, make improvements, and create more streamlined processes. We will share examples of the reviews performed and how revenue integrity was able to benefit from the findings and recommendations.

Breakout Session 9.2
*Info Coming Soon! 

2:00 p.m. – 3:00 p.m.
Breakout Sessions 10

Breakout Session 10.1
Taking Charge of Your Charge Capture
Rebecca Haworth, MHA, BSN, RN, and Sherry Nardi

A hospital’s financial health includes ensuring that all appropriate charges are captured during a patient’s stay. There are many things that can go awry, impacting charge integrity and resulting in revenue leakage. These include lack of a strong understanding by all stakeholders of the billing process, personnel turnover, complexity/volume of coding requirements, and coding/billing mismatches. Even the EHR and its automation can cause system errors. A strong charge capture program, whether manual or automated, is key, aiding in the preservation of revenue integrity. This session will offer discuss solutions to these challenges and methods to support the organization’s financial health.

Breakout Session 10.2
Telehealth: The New Normal
Joy Krush, RHIT, CCS, CCS-P, CDIP

This presentation will review the current state of telehealth rules and regulations and coverage. During the session, polling questions will be used to engage the audience and obtain input of how telehealth services are provided in their respective environments. Case studies from large and small organizations will explore various challenges, opportunities, and solutions.

3:00 p.m.
Symposium Adjourns

— Agenda subject to change —

2023 Revenue Integrity Symposium

Location

Sheraton Charlotte Hotel
555 South McDowell Street, South Tower
Charlotte, NC 28204

• Room rate: $189/night plus taxes and fees
• Hotel cut-off date: Thursday, August 24, 2023. Hotel rooms may sell out earlier than the cut-off date, so book early!
• Reservation Center: 888-855-7741 (reference the Revenue Integrity Symposium room block)
• Reservations URL: https://www.marriott.com/event-reservations/reservation-link.mi?id=1667868166039&key=GRP&app=resvlink
• Hotel website: https://www.marriott.com/en-us/hotels/cltws-sheraton-charlotte-hotel/overview/

Simplify Compliance/HCPro has no affiliation with any third-party companies or travel assistance providers. Rooms should be booked directly with the event hotel using the official information provided on the website and in the brochure.

Pricing

Retail Price: $1,299.00
Early Bird Price: $1,199.00 – Early Bird deadline is June 12, 2023!

NAHRI Member
Retail Price: $1,199.00
Early Bird Price: $1,099.00 – Early Bird deadline is June 12, 2023!

Call Customer Service at 800-650-6787 ext. 4111 and email HCEvents@hcpro.com to receive your Exclusive Member Discount.

Have a group? Contact customer service to receive your group discount today.