ICD-10. Presented by: Lyman G. Sornberger Chief Strategy Officer Capio Partners President & CEO LGS Healthcare Consulting
|
|
- Job Robbins
- 6 years ago
- Views:
Transcription
1 Is That a Light or An Oncoming Train? ICD-10 1 Presented by: Lyman G. Sornberger Chief Strategy Officer Capio Partners President & CEO LGS Healthcare Consulting For over 29 years Mr. Sornberger lead revenue cycle activities for The Cleveland Clinic and UPMC and has consulted with the largest health systems in the country. Those healthcare organizations have revenues that exceed $12 billion. He has authored over 2,200 articles for HFMA, AAHAM, and other leading healthcare publications and has been a featured speaker at over 125 healthcare revenue cycle industry events. 2 1
2 Agenda Why Did We Do This ICD 10? What Did We Hear Prior to the Delay? What Was The Risk? What Is The Reality? What Does The Future Hold? 3 ICD-10 Transition ICD 10 DELAYED GOOD 4 2
3 Why ICD-10? ENHANCED IMPROVE REVNUE BUDGET CARE CYCLE NEUTRAL 5 ICD-10 - Painful Project Education and Awareness Leadership & Board Readiness Technology/Revenue Cycle/Clinical Documentation/People Impact Analysis Financial/Performance/Risk Mitigation/Strategies Implementation Strategy/Planning, Program Charter/Budget Estimates Timeline & Dependencies 6 3
4 7 Operational Gap/Risk Example 300 Bed Hospital $3.5M Missing Doc s $3.5M Doc Improvement $500K Contracting $600K Denials Payment Errors $200K Coding Errors 8 4
5 Remediation Timeline ICD-10 Rem mediation Progressio on Major Remediation Activities Today Computer assisted coding evaluation Project management/governance IT remediation sign-off Remediation workgroups established Finalize ICD-10 training sessions roadmap and timeline ICD-10 Testing Partnerships Test application and interface changes ICD-10 Upgrades Generate test scripts Application interface and use cases upgrades Retest and obtain Establish PMO Ongoing Training for sign-off staff & physicians Establish project charter, work & communication plans Identify ICD-10 super users Workgroups sessions Ongoing staff & physicians ICD-10 training Go-Live & Post ICD-10 Support Execute change management plan Go-live Prep and execute Ongoing staff and physician ICD-10 training Post Optimization Post Monitoring Managing cost Denial Management 9 ICD-10 Analytics Providers overwhelmed about effort for the ICD 10 transition A data driven approach helps providers conserve resources and limit compliance costs minimizing disruptions 10 5
6 ICD-10 [What Risk?] Increased Denials Increased Days in Receivable Underpayments Aged AR Decreased Cash Increased Cost 11 Reality Check Rejected Claims Slightly Above Historical Baseline 99.9% of Claims that Should be Coded in ICD 10 are Accurate Coder Productivity Decline is Less than 10% or No Change at All Resources: Emdeon, Modern Health, Mayo, CMS, and AMA 12 6
7 Reality U ncovered Underpayments are Less then 1% and the Blues Slightly higher, and CMS are at 7% Provider Satisfaction is Up Medicaid Rejections Average is 12% Higher but a Reflection of ACA, Contracts, and Benefit Design Resources: Emdeon, Modern Health, Mayo, CMS, and AMA 13 Smaller Hospitals Beds Inadequate System Commitment Training Documentation Funding Preparation Registration and Orders Challenges Resources: Emdeon, Modern Health, Mayo, CMS, and AMA 14 7
8 Future of Healthcare Beyond 2015 What s next? 15 RCM & HIM Evaluations Not a 30 Day Cycle Assessment Assess reimbursement shifts Coding, Denials & Contracting Engage providers in trends Assess revenue risk Promote strategies to mitigate risk Identify revenue maximization opportunities 16 8
9 RCM & HIM Evaluations Remember the Evils RAC Medicaid Audits Two Midnight Rule LCD and NCD Edits Underpayment After ICD 10 ACA and Benefit Design 17 RCM & HIM Evaluations Remember the Evils Medical Necessity, Auth s and Certs Engage providers in trends Assess revenue risk Promote strategies to mitigate risk Identify revenue opportunities 18 9
10 DRG s at Risk Orthopedics Yes No Maybe 19 Partnership Strategy In house Outsource On/Off Shore Dual Workflow 20 10
11 Fourth Quarter Lessons Learned from Risk Mitigation Verify Revenue Impact Memorialize Future Training Seek Improvement Opportunities: Denial Management Coding CDI, CAC, NLP Automated Coding, etc Benchmark Peer Performance Verify Revenue Impact Benchmark Seek Additional Improvement Opportunities 22 11
12 2017 Establish Performance Targets Verify Revenue Impact Seek Additional Improvement Opportunities Manage Against Reimbursement Changes 23 Questions? Feedback? 24 12
13 Contact Lyman Sornberger Chief Healthcare Strategy Officer c: o
ICD-10 ICD-10: Are you Ready? October 23, 2013
ICD-10 ICD-10: Are you Ready? October 23, 2013 1 Introductions Kristen Hill, HIMformatics Sean Sudduth, HIMformatics 2 Objectives 1. Confirm a baseline understanding of ICD-10 and areas of impact, especially
More information3M Health Information Systems. Real results: A profile of eight organizations boosted by the 3M 360 Encompass System
3M Health Information Systems Real results: A profile of eight organizations boosted by the 3M 360 Encompass System s in progress Every month, more and more organizations academic, non-profit, metro and
More informationTHE NEW WORLD OF HEALTHCARE IN 2017 The Top Five Challenges of Healthcare Leaders 1
THE NEW WORLD OF HEALTHCARE IN 2017 The Top Five Challenges of Healthcare Leaders 1 Lyman Sornberger, Chief Healthcare Strategy Officer, Capio Partners September 23, 2017 There is nothing constant in the
More informationA McKesson Perspective: ICD-10-CM/PCS
A McKesson Perspective: ICD-10-CM/PCS Its Far-Reaching Effect on the Healthcare Industry Executive Overview While many healthcare organizations are focused on qualifying for American Recovery & Reinvestment
More informationICD-10: It s Really Coming. Are You Ready? John Behn May 14, 2013 Small Rural Hospital Improvement Grant Program (SHIP)
ICD-10: It s Really Coming. Are You Ready? John Behn May 14, 2013 Small Rural Hospital Improvement Grant Program (SHIP) Background ICD = International Statistical Classifications of Diseases and Related
More informationICD-10: The First 180 Days. Bonnie Sunday, MD HealthNow New York Inc. HIMSS ICD-10 Task Force Chair
ICD-10: The First 180 Days Bonnie Sunday, MD HealthNow New York Inc. HIMSS ICD-10 Task Force Chair Agenda ICD-10 Background and Timeline Provider Implementation Efforts Hospital Implementation Efforts
More informationICD-10: Beyond Awareness. Now is the time for action!
ICD-10: Beyond Awareness. Now is the time for action! George Vancore Sr. Manager, Delivery Systems Mandates Florida Blue March 19, 2014 AAHAM Orlando, Florida 900-4275-0214 Session Objectives 1. To increase
More informationA Physician Led Comprehensive Coding Compliance Program: Datamining to Disciplinary Action Plans. Optimizing revenue from a compliance perspective
A Physician Led Comprehensive Coding Compliance Program: Datamining to Disciplinary Action Plans Keith Ponitz, M.D. October 16,2012 Agenda Background Optimizing revenue from a compliance perspective Mitigate
More informationAgenda. National Landscape. Background. Optimizing revenue from a compliance perspective. Mitigate the risk: Data mining and coding audits
A Physician Led Comprehensive Coding Compliance Program: Datamining to Disciplinary Action Plans Keith Ponitz, M.D. October 16,2012 Agenda Background Optimizing revenue from a compliance perspective Mitigate
More informationFive Steps to Better ICD-lO Clinical Documentation
Five Steps to Better ICD-lO Clinical Documentation (And why your software depends on it.) Table of... 2 : Evaluate Current Documentation... 3 : Train Physicians...4 : Build a Safe Testing Ground... 5 :
More informationExcellence in Patient Care & High Performance Revenue Optimization
HALO TM Health Information Management Services Leading Provider of End-to-End HIM Services Excellence in Patient Care & High Performance Revenue Optimization End-to-End Health Information Management Services
More informationSuccess with ICD-10: Streamlining Clinical Workflow. November 8, 2013
Success with ICD-10: Streamlining Clinical Workflow November 8, 2013 Culbert Healthcare Solutions Angela Hickman CPC, CEDC, AHIMA-approved ICD-10- CM/PCS Trainer, AHIMA Ambassador Senior Consultant Angela
More informationICD-10: A Cog in a Wheel to Health Care Value
ICD-10: A Cog in a Wheel to Health Care Value Rural Health Conference June 27, 2013 1 Objectives Provide an update on the implementation status of ICD-10 in WI and nationally Focus on the connection between
More informationJanice Redden, CCS, CPC H System Director of Revenue Integrity Phone: E Mail:
Janice Redden, CCS, CPC H System Director of Revenue Integrity Phone: 502 485 4840 E Mail: janice.redden@nortonhealthcare.org Norton Healthcare Faith Based Integrated Delivery Network of Five Not for Profit
More informationUW MEDICINE ICD-10 Program UW MEDICINE ICD-10
UW MEDICINE ICD-10 Program UW MEDICINE ICD-10 There and back again INTEGRATION OF MANDATES ACO Quality Based Reimbursement Meaningful Use, P4P, etc. ICD-10 HIPAA, 5010 2 STRATEGIC OPPORTUNITIES Significant
More informationICD-10 Implementation: No Margin, No Mission
ICD-10 Implementation: No Margin, No Mission October 6, 2014 Subtitle: ICD-WHEN? Page 0 Agenda ICD10 Background ICD9 ICD10 Transition ICD10 Assessment Tasks ICD10 Assessment Considerations ICD-10 Areas
More informationICD-10: The Good, Bad and Ugly
1 ICD-10: The Good, Bad and Ugly Presented by Ken Bradley Vice President of Strategic Planning and Regulatory Compliance Navicure 2 Navicure Learn more or request a demo at www.navicure.com 3 Follow Navicure
More informationENGAGING PHYSICIANS FOR IMPROVED OUTCOMES: CLINICAL DOCUMENTATION, FINANCIAL & PATIENT CARE
ENGAGING PHYSICIANS FOR IMPROVED OUTCOMES: CLINICAL DOCUMENTATION, FINANCIAL & PATIENT CARE Northeast Ohio HFMA GHALI May 20, 2016 James Begley, MD, MS Physician Champion, ICD-10 & Medical Records Committee
More informationDescribe the process for implementing an OP CDI program
1 Outpatient CDI: The Marriage of MACRA and HCCs Marion Kruse, RN, MBA Founding Partner LYM Consulting Columbus, OH Learning Objectives At the completion of this educational activity, the learner will
More informationBenchmarking Patient Access Performance
Revenue Cycle Solutions Benchmarking Patient Access Performance Compare your patient access performance to our 15 best practice benchmarks Advisory Board estimates that the average 350 bed hospital stands
More informationLeon Medical Centers Health Plans will not accept ICD-10 codes until October 1, 2015.
ICD-10 Implementation Frequently Asked Questions Updated August 2015 ICD-10 Compliance Date The U.S. Department of Health and Human Services (HHS) issued a rule on July 31, 2014 finalizing October 1, 2015
More informationOPTIMIZING CLINICAL DOCUMENTATION IMPROVEMENT
OPTIMIZING CLINICAL DOCUMENTATION IMPROVEMENT AT THE INTERFACE OF CLINICAL OPERATIONS AND THE REVENUE CYCLE For most hospitals, Clinical Documentation Improvement (CDI) has become a top priority. As they
More informationResults of Best Practice Research on Hospital RAC Management Preventing and Redressing Audit-Generated Takebacks
Results of Best Practice Research on Hospital RAC Management Preventing and Redressing Audit-Generated Takebacks Our Work To Date Bringing Best Practice Insight to Hospitals and Health Systems Advisory
More informationUsing PEPPER and CERT Reports to Reduce Improper Payment Vulnerability
Using PEPPER and CERT Reports to Reduce Improper Payment Vulnerability Cheryl Ericson, MS, RN, CCDS, CDIP CDI Education Director, HCPro Objectives Increase awareness and understanding of CERT and PEPPER
More informationCapital Hill Briefing on ICD-10: Payer Readiness
George Vancore Florida Blue Sr. Manager, Delivery Systems Mandates and Compliance Tuesday, February 10, 2015 @ 1:30pm Rayburn House Office Building Primary Objectives Increase your awareness and understanding
More informationElizabeth Woodcock, MBA, FACMPE, CPC
Elizabeth Woodcock, MBA, FACMPE, CPC Presentation Topics The Patient-Centered Practice: Creating the Practice of the Future Today Optimizing the workflow of your medical practice operations is difficult
More informationHFMA - Northern California. Otani Consulting Group Inc, Hawthorne Blvd, #216, Torrance, CA 90503
1 HFMA - Northern California 2 Module 2: Departments that Impact Accounts Receivables Clinical and Technical Departments that impact Account Receivables Financial Clearance (FC) Centralized Units Case
More informationCombatting Denials. NJ HFMA January 10, 2017
Combatting Denials NJ HFMA January 10, 2017 1 Denial Challenges PAYER INDUCED Aggressive Commercial Payer Denials (Concurrent and Retrospective) Pre-Payment Review Denials for Medicare Unilateral Payer
More information5D QAPI from an Operational Approach. Christine M. Osterberg RN BSN Senior Nursing Consultant Pathway Health Pathway Health 2013
5D QAPI from an Operational Approach Christine M. Osterberg RN BSN Senior Nursing Consultant Pathway Health Objectives Review the post-acute care data agenda. Explain QAPI principles Describe leadership
More informationOUTPATIENT DOCUMENTATION IMPROVEMENT
OUTPATIENT DOCUMENTATION IMPROVEMENT Pam Brooks, MHA, COC, PCS, CPC Coding Manager Wentworth-Douglass Hospital Dover NH Disclaimer This presentation is for general education purposes only. The information
More informationElectronic Physician Documentation: Increased Satisfaction
Electronic Physician Documentation: Increased Satisfaction Session 222, February 23, 2017 Robert (Bob) Diamond, Sr. Vice President / CIO, Health Quest Kshitij (Tij) Saxena, MD, CMIO, Health Quest 1 Speaker
More informationPresented to you by The Cooperative of American Physicians, Inc.
ICD-10 Action Guide for Medical Practices PAGE 1 Presented to you by The Cooperative of American Physicians, Inc. Table of Contents Introduction... 3 What Is Changing and Why?... 4 What Are the Main Provisions
More informationCAC: Understanding the Technology and Lessons Learned from Early Adopters and The Next Big Thing : Core Measures and Quality Reporting
CAC: Understanding the Technology and Lessons Learned from Early Adopters and The Next Big Thing : Core Measures and Quality Reporting Matt Turner, Regional Manager, Dolbey mturner@dolbey.com What is Computer-Assisted
More informationICD-10: Capturing the Complexities of Health Care
ICD-10: Capturing the Complexities of Health Care This project is a collaborative effort by 3M Health Information Systems and the Healthcare Financial Management Association Coding is the language of health
More informationSEVEN SEVEN. Credentialing tips designed to help keep costs down and ensure a healthier bottom line.
Seven Tips to Succeed in the Evolving Credentialing Landscape SEVEN SEVEN Credentialing tips designed to help keep costs down and ensure a healthier bottom line. 7The reimbursement shift from fee-for-service
More informationBackground and Context:
Session Objectives: Practice Transformation: Preparing for a Value Based Purchasing Environment Susan Brown, MPH, CPHIMS May 2, 2016 Understand the timeline and impact of MACRA/MIPS on health care payment
More informationThe goal is to turn data into information, and information into insight.
aipam Transforming the Patient Financial Experience through Effective Benchmarking Thursday March 10 th, 2016 Suzanne Lestina, FHFMA, CPC VP, Revenue Cycle Innovation Avadyne Health The goal is to turn
More informationClinical documentation improvement/integrity programs (CDIP) have
RAC Preparedness: Five Ideas for Maximizing Your CDI Team Impact W h i t e p a p e r by Lynne Spryszak, RN, CCDS, CPC-A, CDI education director for HCPro, Inc. Background/introduction Clinical documentation
More informationOpen Line Friday: ICD-10
Who s on First: Latest ICD-10 Readiness Survey s and Testing Results January 17, 2014 9:30 a.m. 10:30 a.m. EST Dial Toll-Free: (800) 882-3610 Conference Passcode: 6829655# 900-0000-0114 900-3571-0213 Agenda
More informationMaximizing Relationships within the Revenue Cycle. Chris Johnson CHFP Senior Revenue Cycle Consultant Trubridge, LLC
Maximizing Relationships within the Revenue Cycle Chris Johnson CHFP Senior Revenue Cycle Consultant Trubridge, LLC Agenda History/Background Roles and Responsibilities A walk through the Revenue Cycle
More informationICD-10 Are You Prepared?
ICD-10 Are You Prepared? Hosted by HITECH Answers, Presented by WEDI and Sponsored by ZirMed July 15, 2015 Jim Daley, Past Chair, WEDI; WEDI ICD-10 Co-chair Director, IT, BlueCross BlueShield of South
More informationSharpen coding skills and reimbursement strategies during ICD-10 delay The Centers for Medicare & Medicaid Services (CMS) once again has extended the
Ambulatory Surgery Centers Sharpen coding skills and reimbursement strategies during ICD-10 delay The Centers for Medicare & Medicaid Services (CMS) once again has extended the deadline to begin using
More informationPreparing for ICD-10: Education and Clinical Documentation
Preparing for ICD-10: Education and Clinical Documentation Agenda Background Road to Readiness Education Clinical Documentation Quick Start Today s presentation and recording will be sent to all attendees
More informationTransitioning to ICD-10: An Action Plan for Practices
Transitioning to ICD-10: An Action Plan for Practices By Nancy M Enos, FACMPE, CPMA, CPC-I, CEMC 1 viterahealthcare.com/icd10 The Four T s of Transition to ICD-10: Timing, Training, Testing and Technology
More informationRecovery Audit Contractors: AHA Perspective. Elizabeth Baskett, Policy, AHA February 23, 2012
Recovery Audit Contractors: AHA Perspective Elizabeth Baskett, Policy, AHA February 23, 2012 Agenda Lay of the Land = Audit Overload RACs (Medicare & Medicaid) MACs ZPICs and OIG and DOJ, oh my! AHA and
More informationThe Winding Road to ICD 10 Codesets
The Winding Road to ICD 10 Codesets October 9 th, 2012 Agenda ICD-10 Minnesota Collaborative Update ICD-10 Known Challenges Getting Started Data Analysis Terminology Staffing and budget Training Documentation
More informationMedicare Recovery Audit Contractors. Chicago, IL August 1, 2008
Medicare Recovery Audit Contractors Chicago, IL August 1, 2008 1 Recovery Audit Contractors Demo Summary National Rollout AHA Strategy AHA RACTrac Overview 2 Recovery Audit Contractors Medicare Modernization
More informationRecovery Audit Contractors (RACs) and Medicare. The Who, What, When, Where, How and Why?
Recovery Audit Contractors (RACs) and Medicare The Who, What, When, Where, How and Why? 1 Agenda What is a RAC? Will the RACs affect me? Why RACs? What does a RAC do? What are the providers options? What
More information2014 CODING & DOCUMENTATION UPDATE. Healthcare Services Group November 2013
2014 CODING & DOCUMENTATION UPDATE Healthcare Services Group November 2013 Overview of Topics ICD-10 Implementation 2013 OIG Work Plan Physician, ASC and Hospital 2014 CPT Code Changes 2 ICD-10-CM & ICD-10-PCS
More informationSuccessful ICD-10 Implementation from a Provider Perspective. Monday, April 13, Presented By
Successful ICD-10 Implementation from a Provider Perspective Monday, April 13, 2015 DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent
More informationCentral Ohio HFMA Fall Education Hot Topics: Maintaining Compliance in Times of Change. November 22, 2013
Central Ohio HFMA Fall Education Hot Topics: Maintaining Compliance in Times of Change November 22, 2013 Agenda IPPS Final rule inpatient status changes Proposed OPPS changes to reporting hospital evaluation
More information3M Health Information Systems Should physicians assign their own codes?
3M Health Information Systems Should physicians assign their own codes? The practical guide to striking a coding balance It started with the EHR boom The adoption of electronic health records (EHR) significantly
More informationICD 10 Preparation for NSMM
This document explains regulation changes coming in 2014 that will impact how we collect and document clinical appropriateness using diagnosis codes (ICD-9 conversion to ICD-10). Please familiarize yourself
More informationSNOMED CT AND ICD-10-BE: TWO OF A KIND?
Federal Public Service of Health, Food Chain Safety and Environment Directorate-General Health Care Department Datamanagement Arabella D Havé, chief of Terminology, Classification, Grouping & Audit arabella.dhave@health.belgium.be
More informationThe Fifth National Medicare RAC Summit
The Fifth National Medicare RAC Summit How to Evaluate the Effectiveness of Your RAC Appeal Strategies Are You Maximizing Defense Strategies? Marriot Wardman Park Hotel March 9 11, 2011 Washington, DC
More informationImplementation Issues of the Physician Practice. for ICD-10-CM
Implementation Issues of the Physician Practice for ICD-10-CM What are ICD-10-CM and the Version 5010? The Centers for Medicare & Medicaid Services (CMS) is driving the industry to upgrade core HIPAA transactions
More informationPolling Question #1. Denials and CDI: A Recovery Auditor s Perspective
1 Denials and CDI: A Recovery Auditor s Perspective Tim Garrett, MD Medical Director Barb Brant, RN, CCDS, CDIP, CCS Sr. Clinical Trainer/DRG Auditors Cotiviti, Atlanta, GA 2 Polling Question #1 Does inpatient
More informationMDCH Office of Health Services Inspector General
MDCH Office of Health Services Inspector General Recovery Audit Contract (RAC) Provider Outreach & Education Spring 2014 Background Recovery Audit Contractor Medicare Modernization Act of 2003 created
More informationCompliance Workplan for Physician Practices
Compliance Workplan for Physician Practices Ronda Tews, CPC, CHC, CCP-P St. John s Health System Springfield, MO www.hcca-info.org 888-580-8373 Put together a practical plan for your physician s practice
More informationEmerging Outpatient CDI Drivers and Technologies
7th Annual Association for Clinical Documentation Improvement Specialists Conference Emerging Outpatient CDI Drivers and Technologies Elaine King, MHS, RHIA, CHP, CHDA, CDIP, FAHIMA Outpatient Payment
More informationLearning Objectives INDUSTRY BEST PRACTICES 3/5/2014. Be Ready for ICD-10 Best Practices for Educating Coders. Learn industry best practices for:
Be Ready for ICD-10 Best Practices for Educating Coders Mary Pat Jackey BSN, RN Clinical Educator Commonwealth Health Corporation Bowling Green, KY Michelle Leavitt Director, Learning Solutions HealthcareSource
More informationMary Pat Jackey BSN, RN Clinical Educator Commonwealth Health Corporation Bowling Green, KY. Learning Objectives. Learn industry best practices for:
Be Ready for ICD-10 Best Practices for Educating Coders Mary Pat Jackey BSN, RN Clinical Educator Commonwealth Health Corporation Bowling Green, KY Michelle Leavitt Director, Learning Solutions HealthcareSource
More informationHCA. Coding, Billing, and Documentation Regarding Inpatient, Outpatient, Ambulatory Surgery, and Physician Patient Accounts 3/17/2015
Coding, Billing, and Documentation Regarding Inpatient, Outpatient, Ambulatory Surgery, and Physician Patient Accounts Mark J. Eddy, CPA Vice President HCA Internal Audit 1 HCA Headquarters: Nashville,
More informationCompliance Objectives
Eyeing Coding Compliance and CDI Compliance Programs What Compliance Officers Need to Know or Should Know By Diana Adams, RHIA (adamsrra@tx.rr.com) Compliance Objectives Discovering who are the healthcare
More informationpage 30 MGMA Connexion April MGMA-ACMPE. All rights reserved.
page 30 MGMA Connexion April 2013 Quality Management Deep dive: What lies beneath the surface? Reassessing your credentialing process could mean more money in your practice By Scott T. Friesen Effective
More informationConnecting the Revenue and Reimbursement Cycles
Connecting the Revenue and Reimbursement Cycles Tuesday, August 19 th, 2014 Toni G. Cesta, Ph.D., RN, FAAN Consultant and Partner Case Management Concepts New York Office And Bev Cunningham, MS, RN Vice
More informationAd Space AHIMA NAME 2018 RESOURCE GUIDE CODING & CDI GUIDE
Ad Space AHIMA NAME 2018 RESOURCE GUIDE 53 CODING & CDI GUIDE 54 EDUCATION CODING & CDI & PROFESSIONAL GUIDE / April 2018 DEVELOPMENT GUIDE / February 2018 CONTENTS Administrative Consultant Service, LLC...62
More informationClinical Operations. Kelvin A. Baggett, M.D., M.P.H., M.B.A. SVP, Clinical Operations & Chief Medical Officer December 10, 2012
Clinical Operations Kelvin A. Baggett, M.D., M.P.H., M.B.A. SVP, Clinical Operations & Chief Medical Officer December 10, 2012 Forward-looking Statements Certain statements contained in this presentation
More informationObservation vs. Inpatient: How to Get it Right. November 5, 2013
Observation vs. Inpatient: How to Get it Right November 5, 2013 Learning Objectives Understand how the Inpatient Prospective Payment System (IPPS) Final Rule impacts your facility Integrate leading practice
More informationAn Orientation to ICD 10: A Provider and Payer Perspective
An Orientation to ICD 10: A Provider and Payer Perspective Lee Ratliff, Baptist Health South Florida George Vancore, Florida Blue September 21, 2012 9:30 a.m. 10:30 a.m. EST Dial Toll Free 1 (800) 882-3610
More informationPAeHI On the Road. ICD-10 Workshop. Hahnemann University Hospital. October 17, Behrakis Grand Drexel University
PAeHI On the Road ICD-10 Workshop Hahnemann University Hospital October 17, 2013 Behrakis Grand Hall @ Drexel University 32 nd and Market Streets Philadelphia, PA 19104 Agenda Our Hospital ICD 10 Basics
More informationClinical Documentation Improvement: Best Practice
Revenue Cycle Solutions Consulting and Management Services Clinical Documentation Improvement: Best Practice Our mission: To help you finance yours. 2 Managing Your Audio Use Telephone Use Microphone and
More informationReadying the Compliance Department for ICD-10 HCCA Regional Annual Conference Orlando, Florida
Readying the Compliance Department for ICD-10 HCCA Regional Annual Conference Orlando, Florida February 6, 2015 Agenda Getting Re-Engaged for ICD-10 Systems & Tools Provider Training Case Studies Coder
More informationBundled Payments. AMGA September 25, 2013 AGENDA. Who Are We. Our Business Challenge. Episode Process. Experience
Bundled Payments AMGA September 25, 2013 Who Are We AGENDA Our Business Challenge Episode Process Experience 1 Cleveland Clinic is transforming Fee for service Fee for value 3 Fast Facts 41,200 employees
More informationBecoming a Champion of Physician and Hospital Alignment: Focusing on Length of Stay, Discipline and Standards of Care
Becoming a Champion of Physician and Hospital Alignment: Focusing on Length of Stay, Discipline and Standards of Care Marc Tucker, DO Senior Director Audit, Compliance & Education AHA Solutions, Inc.,
More informationJune 17, Outreach Efforts for HIPAA Transactions/5010
Statement of the American Medical Association to the National Committee on Vital and Health Statistics Subcommittee on Standards Regarding the Industry Implementation of Updated and New HIPAA Standards
More informationHealthcare Solutions Nuance Clintegrity Quality Management Solutions. Quality. The Discipline to Win.
Quality. The Discipline to Win. Brochure 2 It s not wanting to win that makes you a winner; it s refusing to fail. Peyton Manning, the first NFL quarterback to achieve 200 career wins (regular and post-season)
More informationACO Practice Transformation Program
ACO Overview ACO Practice Transformation Program PROGRAM OVERVIEW As healthcare rapidly transforms to new value-based payment systems, your level of success will dramatically improve by participation in
More informationICD-10 STARTS WITH PROVIDERS
ICD-10 STARTS WITH PROVIDERS Steve Arter, CPC Managing Member Hawaii, LLC 765 Amana Street, Suite 302, Honolulu, HI 96814 hcchhawaii.com 808.947.2633 THANK YOU FOR JOINING US WHO IS HERE TODAY HEALTHCARE
More information9/10/2016. What is a Cycle? Learning Objectives
Keep the Cycle Going: Maintaining a Healthy Long Term Care Revenue Cycle and Key Strategies for Successful Reimbursement Management September 29, 2016 What is a Cycle? By law of periodical repetition,
More informationWhat s Up Wednesday. Together Let s Get ICD-10 Ready. Date: September 18, 2013 Time: 2pm 3pm Phone Number: Pass Code:
What s Up Wednesday Together Let s Get ICD-10 Ready Date: September 18, 2013 Time: 2pm 3pm Phone Number: 800-882-3610 Pass Code: 5411307 Presented by the Pennsylvania Blues Plans What s Up Wednesday Increase
More informationFlorida Blue Clinical Documentation Improvement Program (CDI)
Florida Blue Clinical Documentation Improvement Program (CDI) Why Are CDI Programs Important? Clinical documentation is at the core of every patient encounter. In order to be meaningful, it must be accurate,
More informationTraining for ICD-10: A Complete Plan Extends Beyond Coders
Training for ICD-10: A Complete Plan Extends Beyond Coders ICD-10 training discussions have primarily centered around medical coders. As providers experienced with MS-DRGs, however, effective clinical
More informationVickie McElarney Vickie has over 30 years of healthcare experience that encompasses bedside nursing, AVP in hospital operations, Director of Coding, C
Kristi Morris Kristi has over 17 years of healthcare in roles ranging from Front Desk Receptionist, Registrar, Patient Access Supervisor/Manager, Corporate Manager of Outpatient Rehab/Physician Scheduling,
More informationICD-10 is Financially Disastrous for Physicians
Kathleen Sebelius Secretary US Department of Health and Human Services Hubert H Humphrey Building, Room 445-G 200 Independence Avenue, SW Washington, DC 20201 Dear Secretary Sebelius: On behalf of the
More informationIMAGES & ASSOCIATES O UR S ERVICES OPERATIONAL REVIEW AND ENHANCEMENT
O UR S ERVICES OPERATIONAL REVIEW AND ENHANCEMENT The Prospective Payment System (PPS) for Inpatient Rehabilitation Facilities creates both opportunities and challenges for facilities that provide comprehensive
More informationClinical Program Cost Leadership Improvement
Clinical Program Cost Leadership Improvement December 2017 Presbyterian recently developed a rapid-cycle process for integrating sustainable cost and quality improvements within clinical programs. Population
More informationAdvisory Board Fellows
Talent Development Advisory Board Fellows Delivering impact through a signature initiative Talent Development s marquee leadership program, the Advisory Board Fellowship, is an accelerated two-year, MBA-like
More informationPSI-15 Lafayette General Health 2017 Nicholas E. Davies Enterprise Award of Excellence
PSI-15 Lafayette General Health 2017 Nicholas E. Davies Enterprise Award of Excellence Rachel Brunt, RN, BSN, MBA-HCA, CIC, CPHQ, Director Quality Jessie Hanks, BS, RHIA, Director HIM Lafayette General
More informationTwo birds with one stone Financially Clearing a Patient & and Improving Patient satisfaction at the same time
Two birds with one stone Financially Clearing a Patient & and Improving Patient satisfaction at the same time Manoj Chhabra DCS Global Systems, Inc. Presentation Agenda Objectives Problem Defined Patient
More informationRegulatory Compliance Risks. September 2009
Rehabilitation Regulatory Compliance Risks September 2009 1 Agenda - Rehabilitation Compliance Risks Understand the basic requirements for Inpatient Rehabilitation Facilities (IRFs) and Outpatient Rehabilitation
More informationICE 2016 Annual Conference December 5, 2016
ICE 2016 Annual Conference December 5, 2016 The Coded Division of Financial Responsibility (DOFR) Stephen J. Linesch S. Linesch and Associates Carol Wanke Vice President, Managed Care Operations Sharp
More informationAligning Organizational Priorities: Integrating the Physician to Drive Operational Success
Aligning Organizational Priorities: Integrating the Physician to Drive Operational Success Mary Beth Briscoe, CPA, MBA, FHFMA, FACHE Chief Financial Officer-University Hospital Elizabeth Turnipseed, MD,
More informationGrow Your Own Coders: Training Options for the Modern HIM World
Grow Your Own Coders: Training Options for the Modern HIM World Healthcon 2016 April Date 13, 2016 Presentation by Pamela Haney, MS, RHIA, CCS, CIC, COC Director of Presentation Training and byeducation
More informationInnovative Technology Solutions for Medicare Patients and Providers
Innovative Technology Solutions for Medicare Patients and Providers Sharon Hibay, RN, DNP Sr. Director, Quality Measurement & Innovation shibay@livanta.com Lance N. Coss, MS, MEd, CGC BFCC-QIO Program
More informationAgenda. OIG Medicare Compliance Reviews: A Compliance Officer s Guide to Survival. Introduction History and Purpose Facility Selection Evolution
OIG A Compliance Officer s Guide to Survival Shannon DeBra Bricker & Eckler LLP sdebra@bricker.com Linn Swanson UPMC swansonlm@upmc.edu Agenda Introduction History and Purpose Facility Selection Evolution
More informationOntario Shores Journey to EMRAM Stage 7. October 21, 2015
Ontario Shores Journey to EMRAM Stage 7 October 21, 2015 ICE BREAKER Agenda System overview & pervasiveness of use Review Clinical Practice Guideline implementation Discuss Patient Portal implementation
More informationCMS IPPS 2014 Final Rule: Physician Education on Observation Status and 2-Midnight Rule
CMS IPPS 2014 Final Rule: Physician Education on Observation Status and 2-Midnight Rule John Zelem, MD, FACS Executive Medical Director Audit, Compliance and Education (ACE) AHA Solutions, Inc., a subsidiary
More informationUnitedHealthcare Medicare Readmission Review Program for Medicare Advantage Plans General Clinical Guidelines for Payment Review
UnitedHealthcare Medicare Readmission Review Program for Medicare Advantage Plans General Clinical Guidelines for Payment Review Introduction The UnitedHealthcare Medicare Readmission Review Program is
More informationClinical Documentation Improvement
Clinical Documentation Improvement Measures, Models, and Multi-facilities Patty Dietz RN, BSN, CPHQ Midas+ Solutions Consultant Sara Wagner MHA Business Analyst The Ohio State University Wexner Medical
More information