We cordially invite you to a lecture and Q&A seminar presented by AccretivePAS®. AccretivePAS® offers an integrated approach to assist health care providers in establishing compliance and revenue integrity.
As hospitals are under increased scrutiny by an increasing numbers of auditing agencies regarding level of care and medical necessity, it is crucial that facilities have experts trained in understanding the rules, regulations and guidelines that serve as the roadmap for these audits. This course will train physicians, nurses, social workers and other interested individuals to be expert resources for their hospitals and to allow them to guide the development of operational improvements at their facilities to reach best practice.
This activity has been designed to meet the educational needs of CEO, CFO, COO, CIO, Utilization Review/Case Management, HIM, Revenue Cycle, ITD, clinical leadership, physician advisors, compliance officers and RAC team members involved in the care of patients with medical necessity status recommendation requirements.
After completing this activity, the participant should be better able to:
Summarize Medicare regulations governing hospital admission, use of outpatient beds and observation.
Explain the importance of physician document of medical necessity and how it can protect hospitals from payment denials.
Describe the role of the physician advisor in assisting physicians and hospitals in determining proper admission status and obtaining the required documentation
Differentiate the various Medicare auditors reviewing hospital billing practices including their target areas, powers and tactics
Explain the role of case management in hospital compliance.
Commission for Case Manager Certification
*This program has been pre-approved by the Commission for Case Manager Certification to provide continuing education credit to Certified Case Managers (CCMs). Total number of clock hours - 6.0.
Continuing Medical Education Credits
The Postgraduate Institute for Medicine designates this live activity for a maximum of 6.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Postgraduate Institute for Medicine and Accretive PAS. The Postgraduate Institute for Medicine is accredited by the ACCME to provide medical education for physicians.
8:15 a.m. – 8:30 a.m. Welcome and Introductions (Complimentary Breakfast Served)
8:30 a.m. – 10:00 a.m. Managing Compliance Challenges in Today’s Complex Regulatory Environment
10:00a.m. – 10:15 a.m. Break
10:15 a.m. – 11:00 a.m. The Role of the Physician Advisor in the RAC Era - Opportunities and Limitations
11:00 a.m. – 11:45 a.m. Regional and National Hot Topics in Compliance and Denials Management
11:45 a.m. – 12:30 p.m. Complimentary Lunch Served with Open Forum Q&A Session
12:30 p.m. – 1:30 p.m. Inpatient versus Outpatient Procedures and the Use of Observation: Avoiding Pitfalls while Remaining RAC Compliant
1:30 p.m. – 2:15 p.m. Medical Necessity - The Sequel - Beyond Observation and Inpatient
2:15 p.m. – 3:00 p.m. Wrap Up and Q&A
Steven J. Meyerson, M.D. serves as Vice President of Physician Advisory Services (AccretivePAS®) in the Regulation and Education Group (“the REG Specialists”) where his role includes physician education on RAC activities and the latest Medicare guidelines. Dr. Meyerson is board certified in internal medicine and geriatrics. Prior to his employment at AccretivePAS®, Dr. Meyerson served as Medical Director of the hospitalist program at Baptist Hospital of Miami and then for four years was full time Medical Director and Physician Advisor for Care Management at that hospital.
Ronald Hirsch, M.D. serves as Vice President of Physician Advisory Services (AccretivePAS®) in the Regulation and Education Group (“the REG Specialists”). Prior to his employment at Accretive Health, Dr. Hirsch, a board certified internist and HIV specialist, practiced and served as president at a multispecialty practice in Illinois and Medical Director of Case Management at Sherman Hospital in Elgin, IL.
Postgraduate Institute for Medicine (PIM) requires instructors, planners, mangers and other individuals who are in a position to control the content of this activity to disclose any real or apparent conflict of interest they may have as related to the content of this activity. All identified conflicts of interest are thoroughly vetted by PIM for fair balance, scientific objectivity of studies mentioned in the materials or used as the basis for content, and appropriateness of patient care recommendations.
Americans with Disabilities Act
Event staff will be glad to assist you with any special needs (ie, physical, dietary, etc). Please contact Joe Evans prior to the live event at 312.462.6219.
Parking information to follow.
When & Where
Best Practices in Medical Necessity Compliance brought to you by the Regulation and Education Specialists at AccretivePAS®