Education Series. The Revenue Integrity Forum Proudly Presents. Keeping the Beat in Today s Changing HealthCare Environment

Transcription

1 The Revenue Integrity Forum Proudly Presents Keeping the Beat in Today s Changing HealthCare Environment Tuesday, June 14, 2016 Betsy Weiss, Chair and Eric Shubin, Co-Chair Renaissance Woodbridge Hotel Iselin, NJ 08830

2 Registration and Breakfast: 7:30 a.m. to 8:30 a.m. Education Sessions: 8:30 a.m. to 4:00 p.m. 8:30 a.m. to 8:45 a.m. Welcome - Induction of Officers and Announcements of Scholarship Recipients 8:45 a.m. to 9:00 a.m. NJHA Update 9:00 a.m. to 10:00 a.m. Life, Liberty and the Future of the Chargemaster (CDM) The reimbursement landscape is shifting from payments based upon submitted charges to payment models grounded in outcomes and performance. This session will explore the possible evolution of the CDM as many are questioning how the CDM will evolve in future years. Those attending will be better positioned to guide their organization s strategic use of the CDM in both the short and long term. How the CDM has historically changed during periods of transition in healthcare What these past adaptations might tell us about the future of the CDM A survey of the future of charge capture, and thus the CDM, within the revenue cycle The role of the CDM in patient estimation The probable future state of the CDM moving forward Kelly Pompea, RT(R), RCC Regional Director of Enterprise Solutions ZirMed Govi Goyal, MS Regional Director of Enterprise Solutions ZirMed 10:00 a.m. to 10:15 a.m. Break

3 10:15 a.m. to 11:20 a.m. Avoiding Red Flags: Documentation and Billing Compliance for High Cost Drugs & Devices There has been heightened scrutiny and requirements for transparency by the RACs, MACs and CERTS for high costs drugs and devices. During this session we will discuss the ways to decrease denials with supporting documentation and mitigating risk by identifying common errors. Discuss clinical documentation requirements to support medical necessity Identify common coding and billing errors to mitigate compliance risk and optimize reimbursement Provide key strategies to improve compliance with documentation, coding, and billing regulations Sandy Piersol Compliance Officer McBee Associates, Inc. 11:20 a.m. to 11:30 a.m. Break 11:30 a.m. to 12:30 p.m. Medicare and Medicare Advantage: Avoid Waving the White Flag and Surrendering Your Reimbursement 2016 brings the resumption of the RAC short stay audits after a nearly three year hiatus but that is not the only issue affecting health systems. Expensive new technologies, physician practice acquisitions, and increasing use of outpatient services are all under the watchful eye of auditors. This session will prepare you to avoid take backs and increased audit activity. Understand the new short stay audit program and develop compliant processes to avoid denials Review the common audit risks of hospital-owned physician practices Prepare for increased scrutiny of outpatient service audits Dr. Ronald Hirsch, MD. FACP, CHCQM Vice President, Regulations and Education Accretive Physician Advisory Services

4 12:30 p.m. to 1:15 p.m. Lunch 1:15 p.m. to 2:45 p.m. How to Keep the Flag Flying: Maintaining Revenue Integrity in a Bundled Payment World This panel discussion will focus on the development and evolution of bundled payment models and the potential benefits to both payers and providers. Our panelists will discuss their experiences and will share their strategies and lessons learned. Understand the ever changing role of the Revenue Integrity Team Review cost to charge relationships Explore how to prepare for the transition in reimbursement Review considerations related to CDM and contract management systems Dr. Ronald Hirsch, MD. FACP, CHCQM (Moderator) Vice President, Regulations and Education Accretive Physician Advisory Services David Wagner Market Manager Remedy Partners Caroline Rader Znaniec, MBA, MSM Owner Luna Healthcare Advisors LLC Robin Brown-Stovall, MBA, RHIA, CPC Sr. Director, Claims Processing and Revenue Integrity Hospital Revenue Cycle Thomas Jefferson University Hospitals Tracy A. Davison-DiCanto, CLSSGB, COC-A, FHFMA, MBA Executive Director, Network Services Princeton HealthCare System 2:45 p.m. to 3:00 p.m. Break

5 3:00 p.m. to 4:00 p.m. The Wave of the Future: Understanding the Impact of Quality Reporting on the Revenue Cycle Quality reporting continues to expand in all patient care settings and is becoming increasingly linked to payment for services. It also impacts many parts of the revenue cycle such as charge strategies, pricing, charge capture, payor contracts, payment reconciliation, and systems to name a few. The shift from Fee-for-Service payment to Value-based-Reimbursement makes it important for everyone within the revenue cycle to have an understanding of this new environment. This session will help you to understand how quality reporting is impacting your revenue cycle. Brief review of Hospital Value Based Purchasing Programs Discuss the impact of quality outcomes data Review the impact on revenue cycle processes and financial reimbursement Discuss best practice strategies Kim Charland, BA, RHIT, CCS Publisher of VBPmonitor and Senior Vice President, Clinical Innovation, Panacea Healthcare Solutions, Inc. 4:00 p.m. to 5:00 p.m. Adjournment & Happy Hour Generously Sponsored by: Craneware EDUCATION CREDITS NEW JERSEY BOARD OF ACCOUNTANCY CONTINUING PROFESSIONAL EDUCATION CREDITS Based on our understanding of the New Jersey State Board of Accountancy s continuing professional education (CPE) requirements, Sponsor No. 185, this course will qualify for 7.0 CPE credits. (7.0 CPE in Specialized Knowledge). AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES CONTINUING EDUCATION CREDIT The New Jersey Chapter of the Healthcare Financial Management Association is authorized to award 6.0 hours of pre-approved Category II (non-ache) continuing education credit for this program toward advancement, or recertification in the American College of Healthcare Executives. Participants in this program wishing to have the continuing education hours applied toward Category II credit should indicate their attendance when submitting application to the American College of Healthcare Executives for advancement or recertification. AMERICAN ACADEMY OF PROFESSIONAL CODERS CONTINUING EDUCATION CREDIT Note: 6.0 Credit hours are pending approval. SUPREME COURT OF NEW JERSEY BOARD ON CONTINUING LEGAL EDUCATION Based on our understanding of the Supreme Court of New Jersey Board on Continuing Legal Education mandatory continuing legal education program requirements, this course will qualify for 7.0 CLE credits. NJ HFMA is an approved service provider (#1098).

6 To register online, please visit our website at where online payment submission is also available, but not required. If you prefer to register by mail, please list your attendees and follow the registration instructions presented below. NAME ORGANIZATION TITLE HFMA MEMBER or NON-MEMBER ADDRESS FEE: ADVANCE REGISTRATION MEMBERS... $135 ADVANCE REGISTRATION NON-MEMBERS... $160 ADVANCE REGISTRATION CERTIFIED MEMBERS (FHFMA, CHFP)... $100 STUDENT REGISTRATION... $35 ON-SITE REGISTRATION, ON SPACE AVAILABLE BASIS... $25 extra REGISTRATION INFORMATION: Registration is available online at or by mail. Make checks payable to HFMA - NJ CHAPTER, and please mail at least 10 days prior to the event. Registration must be received three working days prior to the event. REFUNDS WILL BE GRANTED ONLY IF CANCELLATION IS RECEIVED 48 HOURS PRIOR TO THE MEETING. Dress is Business Casual. Mail payment to: HFMA NJ Chapter Laura Hess P.O. Box 6422 Bridgewater, NJ08807 Phone number for questions is (888) NJC-HFMA. In the event of questionable weather or other emergency affecting a significant number of members, please call NJC-HFMA or check the Chapter website no earlier than two hours prior to the start of registration for the event to confirm status of event.