NOTE:   Program will be held in Reno (11/16), then repeated in Las Vegas (11/17).  Each educational session will begin at 5:30 PM, and will be followed immediately by a social mixer. Please register for the location you plant to attend.

Approved ACHE Cat II Education

Keeping Physicians in Business Will Help CEOs Stay in Business when Everyone Understands Reimbursement Issues

Physician engagement for hospitals is a challenge as fewer private practice physicians and specialists are reluctant to deal with the challenges of a hospital practice. Regulatory agencies are gearing up for provider reviews, which often gives physicians a false sense of security by not using high level codes for services provided to ward off ‘reviews.’ What this triggers is use of lower level codes, ultimately questioning medical necessity of admissions. A CEO must understand the challenges of the business of medicine from the physician’s perspective and seek ways to foster win-win strategies. If a hospital continues to acquire physician practices, the onus of effective documentation does not diminish. This lecture is intended for a general audience consisting of Physicians, CEOs, Nurse Executives, Allied Health Practitioners, Clinicians, and other healthcare professionals.

Educational Goals

After listening to the presentation, participants will be able to: 

1.                  To understand why physicians/physician practices need to understand reimbursement issues related to inpatient care provided

2.                  To help CEOs and leaders understand how physician use of appropriate CPT codes for inpatient services provided by physicians to patients in a licensed acute care hospital setting has a positive impact on hospital coding

3.                  To understand coding changes for attending physicians when consultants are involved in patient management

4.                  To be informed about Medicare regulations including use of mid-level   practitioners

5.                  To recognize the importance of collaborating with physicians to engage them in  proper documentation

6.                  To become compliant/be aware of compliance with Medicare guidelines related to billing for professional services to patients in acute and subacute facilities

This workshop will discuss:

1.                  CEO response to an inquiry by an external review organization related to physician practice (case study)

2.                  CEO response when an external review organization requires the hospitals to develop systems for monitoring physician documentation (case study)

3.                  How CEOs can foster engagement when dealing with the private practitioner

4.                  Why CEOs need to focus on effective billing practices for hospital-managed or owned physician practices

5.                  Methods for streamlining documentation in non EMR settings

• Reno Social hosted by Colin O'Sullivan, FACHE and sponsored by Tahoe Pacific Hospitals.

• Las Vegas Social hosted by Teressa Conley, FACHE and sponsored by St. Rose Dominican Hospitals.