2018 Critical Access Hospital Conference Agenda June 14-15, 2018

Transcription

1 Day Type Session Start End Thursday Breakfast 7:30 AM 8:30 AM Thursday General Session Welcome/State of the Industry 8:30 AM 9:15 AM Thursday Concurrent Revenue Cycle Track: Compliance and Charge Capture: They Are Not Mutually Exclusive Thursday Concurrent Reimbursement/Cost 9:15 AM 10:30 AM 9:15 AM 10:30 AM Thursday Break 10:30 AM 10:45 AM Thursday Concurrent Revenue Cycle Track: 10:45 AM 12:00 PM Implementing an Effective Denials Management Program Thursday Concurrent Reimbursement/Cost 10:45 AM 12:00 PM Thursday Lunch 12:00 PM 1:00 PM Thursday Concurrent Revenue Cycle Track: 1:00 PM 2:15 PM HIM in the Electronic Era Thursday Concurrent Reimbursement/Cost 1:00 PM 2:15 PM Thursday Break 2:15 PM 2:30 PM Thursday Concurrent Revenue Cycle Track: MACRA 2018: What s New and Around the Bend? 2:30 PM 3:45 PM

2 Day Type Session Start End Thursday Concurrent Reimbursement/Cost 2:30 PM 3:45 PM Thursday Keynote The Richest Man in Town 3:45 PM 4:45 PM Thursday Cocktail reception 5:00 PM 6:00 PM Day Type Session Start End Friday Breakfast 7:30 AM 8:30 AM Friday Concurrent Revenue Cycle Track: Business Office Outsourcing Contracting and Audit 8:30 AM 9:45 AM Friday Concurrent Reimbursement/Cost 8:30 AM 9:45 AM Friday Break 9:45 AM 10:15 AM Friday General Session The Revenue Cycle / 10:15 AM 11:15 AM Cost Report Connection Friday Closing 11:15 AM 11:30 AM Compliance and Charge Capture: They Are Not Mutually Exclusive Thursday, June 14, :15 a.m. 10:30 a.m. CT Compliance and operations initiatives often overlap. In this session, we ll discuss the project work that these two areas perform and how their goals can align with one another. Understand compliance in a critical access hospital setting Review the differences and similarities between compliance and charge capture/operational initiatives Discuss examples and scenarios that would change a compliance project into a charge capture project and vice versa

3 Amy Tepp, CPA Director of Revenue Cycle Amy has more than 30 years of experience in health care finance, leadership, reimbursement, revenue cycle, and compliance. She has worked in the capacity of, Medicare Auditor, Director of Reimbursement, Revenue Integrity, Regulatory Review and Analysis, Compliance Officer, and Consultant. Amy assists providers by developing solutions focusing on revenue cycle process optimization, chargemaster development, compliance program assessment and compliance audit function. Rachel Pugliano, RHIT Sr. Manager, Coding Services Rachel has more than 20 years of experience in health care coding, coding compliance and documentation improvement and education services. She began her health care career as a coder in a large multi-specialty physician practice but transitioned into a compliance role for both providers and hospitals/health systems for most of her career. Rachel has been consulting with hospitals, health systems and provider practices for more than five years. She assists providers by developing solutions focusing on accurate code assignment, charge capture process improvement, chargemaster development, billing compliance, documentation improvement and education of both providers and clinicians. Cost Reporting: Thursday, June 14, :15 a.m. 10:30 a.m. CT Thursday, June 14, :00 p.m. 2:15 p.m. CT Thursday, June 14, :30 p.m. 3:45 p.m. CT Friday, June 15, :30 a.m. 9:45 a.m. CT This interactive day and a half course covers the fundamental components of the critical access hospital cost report. This focused training includes detailed discussion of the actual worksheets of the Medicare cost report, information needed for completion of the cost report and how the cost report determines your Medicare reimbursement. The session will also explore best practices and strategies for optimizing reimbursement and also how you can use your cost report to aid in future decision making. Understand the purpose of the Medicare cost report and its role in determining critical access hospital reimbursement Explore key items in the cost report that affect your Medicare reimbursement and develop strategies to improve reimbursement Understand how the revenue cycle impacts your Medicare cost report and the role it has in determining Medicare reimbursement on your cost report

4 Brian Bertsch Principal Brian has more than 20 years of experience helping critical access hospitals improve their financial stability. He specializes in assisting critical access hospitals on compliance with Medicare, Medicaid and other third-party reimbursement rules and regulations to achieve proper reimbursement for services performed. Brian also provides education to critical access hospital staff, board members and constituents on Medicare reimbursement for critical access hospitals. Taylor Wolf I Consulting Senior Associate Taylor has more than three years of experience in the health care industry, assisting providers with amended cost reports, re-openings of cost reports and reviews of third party audits. In her role with Eide Bailly, she prepares Medicare and Medicaid cost reports for critical access hospitals, rural health clinics and other providers. She also works on various provider-specific projects such as Wage Index analyses, 340B program implementations, and third-party settlement modeling. Alicia Amundson I Reimbursement Senior Manager Alicia has more than 17 years of experience in the health care industry, including 10 years in the provider audit and reimbursement at a Medicare Administrative Contractor. In her role with Eide Bailly, she completes reviews and analyzes Medicare cost reports, conducts reimbursement projects, and provides assistance in estimating Medicare contractual allowances and cost reports receivables/payables estimates. Ralph Llewellyn, CPA, CHFP Director of Critical Access Hospitals Ralph has more than 22 years of experience in health care finance, leadership, reimbursement and operations. He began his health care career as a hospital CFO for a 49-bed hospital with a 116-bed nursing home. Ralph has been with Eide Bailly for more than 18 years and is currently the director of critical access hospitals and health care consulting. He assists providers by developing solutions focusing on cost report reimbursement, chargemaster development, billing compliance, operations leadership, organizational structure, process flow, board education, licensure status and electronic health record incentives. Implementing an Effective Denials Management Program Thursday, June 14, :45 a.m. 12:00 p.m. CT This session will explore the knowledge and tools needed to implement an effective denials management program, moving from reactively responding to denials to managing and preventing denials. We ll review statistics from independent sources that demonstrate the prevalence of denials as well as common reasons for denials and ways to help understand the frequency and dollar value of denials, by reason, in order to prioritize your denials management efforts.

5 In addition, we ll explore how to identify who needs to be represented on your team from various departments to have the proper controls in place to effectively manage and prevent denials in the future. Understand and define denials in your organization Identify areas in the revenue cycle that may cause denials Discuss best practices to minimize denials Review key performance indicators for denials Marie Murphy, CHFP I Health Care Revenue Cycle Consulting Manager Marie has more than 23 years of revenue cycle experience and has worked with the health care industry throughout her career. Her health care leadership experience includes end-to-end revenue cycle management from concept to transformation and ongoing monitoring and process improvement (e.g., pre-arrival, patient access, financial counseling, revenue integrity). Marie is proficient in process improvement and has studied the Deming System in process improvement. She provides revenue cycle and operational assessments, and chargemaster reviews. Marie holds the CHFP designation and is currently the Minnesota Gopher Chapter President of AAHAM. Health Information Management in the Electronic Era Thursday, June 14, :00 p.m. 2:15 p.m. CT The role of Health Information Management (HIM) has evolved with the emergence of electronic health records and other paperless systems. We will discuss the legal aspects of these changes as well as focus on HIM s role in record completion/analysis and the design of electronic health record (EHR) processes. Understand the standards that govern the legal health record Understand the Medicare Conditions of Participation standards Discuss unique critical access hospital accreditation standards Define quality documentation and share delinquency/deficiency monitoring tools Review aspects to consider when converting to a new EHR system Rachel Pugliano, RHIT Sr. Manager, Coding Services Rachel has more than 20 years of experience in health care coding, coding compliance and documentation improvement and education services. She began her health care career as a coder in a large multi-specialty physician practice but transitioned into a compliance role for both

6 providers and hospitals/health systems for most of her career. Rachel has been consulting with hospitals, health systems and provider practices for more than five years. She assists providers by developing solutions focusing on accurate code assignment, charge capture process improvement, chargemaster development, billing compliance, documentation improvement and education of both providers and clinicians. Sue Roehl, RHIT, CCS I Manager Sue has 40 years of experience in the health care industry specializing in coding, revenue cycle, compliance and health information management. She has been with Eide Bailly for 19 years providing coding, billing and physician documentation reviews. She also assists clients with compliance, HIM operations, and privacy. Sue has served twice as the President of the North Dakota Health Information Management Association and is the current Coding Roundtable Coordinator. She is an AHIMA approved ICD-10 trainer. Sue enjoys assisting clients in researching coding and billing issues to assure appropriate reimbursement. MACRA 2018: What s New and Around the Bend? Thursday, June 14, :30 p.m. 3:45 p.m. CT You ve (maybe) submitted your 2017 performance year data. In this session, we ll review what happens next, whether you submitted or not. What changes are happening or expected for performance year 2018? How will reporting be different when that time comes? Quality is currently the highest weighted category in your Merit-based Incentive Payment System (MIPS) score but that will shift to cost by What does this mean for your organization? This session will address these questions as well as provide education around accountable care organizations, data analysis, the Centers for Medicare and Medicaid Services (CMS) technical assistance, hierarchical condition categories, and key strategic recommendations for being successful in the world of Medicare Access and CHIP Authorization Act (MACRA). Understand MACRA state of affairs for 2018 and what to expect when reporting in 2019 Review the impact of the MIPS scoring weight shifting from quality to cost Discuss data analysis, CMS technical assistance and Hierarchical Condition Categories Discover key strategic recommendations for being successful in the world of MACRA Adam Strom, MBA Health Care Consulting Manager Adam has more than 15 years of health care industry experience, including work with developmentally disabled adults, community mental health case management and crisis intervention, public health quality improvement, and now strategic operational consulting with Eide Bailly. Adam has enjoyed working with locations around the United States as they create strategic plans, perform community health needs assessments, and navigate the ups and

7 downs of population health management and value based reimbursement models. Adam holds a Masters of Business Administration from Hamline University. Business Office Outsourcing Contracting and Audit Friday, June 15, :30 a.m. 9:45 a.m. CT The decision to outsource business office functions is a difficult one. Selecting an outsource vendor and managing the process is critical to the success of the organization. This session will review the various types of outsourcing services as well as the process for selecting a vendor and ways to ensure key contracting provisions are in your agreements. In addition, we ll review the auditing expectations and reporting a facility should expect when using one of these companies. Understand communication of information with outsourced vendors Review quality assurance process for accuracy Discuss delegation of duties and contract terms Understand expectations for denials management/write off approval Amy Tepp, CPA Director of Revenue Cycle Amy has more than 30 years of experience in health care finance, leadership, reimbursement, revenue cycle, and compliance. She has worked in the capacity of, Medicare Auditor, Director of Reimbursement, Revenue Integrity, Regulatory Review and Analysis, Compliance Officer, and Consultant. Amy assists providers by developing solutions focusing on revenue cycle process optimization, chargemaster development, compliance program assessment and compliance audit function. Nicole Munsterman, RHIT Health Care Consulting Manager Nicole has more than 10 years of experience in health care. She has worked with hospitals and health systems on billing and revenue integrity issues to ensure optimal reimbursement and compliance. In her role with Eide Bailly, she assists providers in coding and billing issues to assure appropriate reimbursement. General Session: The Revenue Cycle/Cost Report Connection Friday, June 15, :15 a.m. 11:15 a.m. CT Facilities are frequently unaware of the connection between the revenue cycle and the cost report. This can lead to decisions in one operational area that create challenges in others. At

8 times, these challenges can lead to lost reimbursement opportunities to the organization. Other times, these challenges may lead to compliance issues. This session will include conversations on the how the revenue cycle and cost reporting processes interact in best practices. Understand the connection between the revenue cycle and cost report processes Identify common challenges between the revenue cycle and cost report that create compliance and reimbursement concerns Identify strategies to enhance the communication and interaction between the revenue cycle and cost report team Brian Bertsch Principal Brian has more than 20 years of experience helping critical access hospitals improve their financial stability. He specializes in assisting critical access hospitals on compliance with Medicare, Medicaid and other third-party reimbursement rules and regulations to achieve proper reimbursement for services performed. Brian also provides education to critical access hospital staff, board members and constituents on Medicare reimbursement for critical access hospitals. Ralph Llewellyn, CPA, CHFP Director of Critical Access Hospitals Ralph has more than 22 years of experience in health care finance, leadership, reimbursement and operations. He began his health care career as a hospital CFO for a 49-bed hospital with a 116-bed nursing home. Ralph has been with Eide Bailly for more than 18 years and is currently the director of critical access hospitals and health care consulting. He assists providers by developing solutions focusing on cost report reimbursement, chargemaster development, billing compliance, operations leadership, organizational structure, process flow, board education, licensure status and electronic health record incentives. Keynote: The Richest Man in Town Based on the best-selling book of the same title, go on an emotional roller coaster ride as V.J. describes how Marty, an unforgettable cashier at a local big box store, had a profound impact on the people who went through his check-out line. Marty became a legend in an unexpected place because he treated everybody with dignity, kindness and respect. As V.J. says, Marty was living proof that you don t need money, power or title to make a difference in life. You just need to care. V.J. Smith, Author of The Richest Man in Town V.J. Smith is a professional speaker and published author. He graduated from South Dakota State University in 1978 and spent a decade working for the Allied Signal Aerospace Company in Kansas City. He returned to his alma mater in 1990, working for six years in the SDSU Athletic Department. He was appointed Executive Director of the SDSU Alumni Association in In January 2007, he left that position to pursue a career in professional speaking. Smith travels the country and makes over 100 speaking appearances a year.