Catalog Number : caa1057
Title : Conducting an APC Audit
Speaker : Duane Abbey

Webplay Recording Date : 4-26-2011
Webplay Price : $ 200 for two weeks viewing

Webinar Overview:

How can we prepare for future compliance issues surrounding APCs? What are the major compliance risks for APCs? Please join this webinar to answer issues surrounding APCs and how to address these issues.

Webinar Objectives:

• Review the main features of the APC payment system
• Understand how the APC grouping logic determines payment for outpatient services
• Discuss the critical aspects of compliance issues surrounding APCs and related encounter driven systems
• Appreciate the extreme importance of correct coding and modifier utilization
• Understand how to develop an overall APC Integrity Program
• Delineate specific types of audits and reviews that are necessary to assure proper payment under APCs
• Understand APC issues that may be addressed in the RAC (Recovery Audit Contractor) program

Webinar Outline:

• Overview of APCs and Encounter-Driven Payment System
  • Coding Systems
  • Overall Grouping Process
  • General Compliance Concerns
  • Quantitative Measures
  • Organizational Structuring – Provider-Based Rule
• Key Definitions and Concepts for APCs
  • CPT/HCPCS Coding
  • Use of Modifiers
  • Surgical Services
  • Evaluation and Management Services
  • Special Areas
    • Observation
    • Emergency Department
    • Interventional Radiology
    • Injections and Infusions
    • Others
• Chargemaster Involvement In APCs
  • Coding Interface
  • Cost Report Interface
  • Charge Devel
• Policy and Procedure Development
  • Coding
  • Billing
  • Chargemaster
• Special APC Audit Areas
  • Correct Coding & Modifier Utilization
  • Emergency Department
  • Provider-Based Clinics
  • Technical Component E/M Levels
  • Observation
  • RAC Audit Issues
• APC Audit Process
  • Selection of Cases
  • Stratification
  • Review Process
• Reports and Recommendations

Target Audience:

• Outpatient Coding Personnel
• Billing and Claims Transaction Personnel
• Internal Auditing Personnel
• Financial and Compliance Personnel
• Physicians
• Other Interested Personnel

Attendance Certificate:

Upon attending this course you will receive a 1.5 Contact Hour Attendance Certificate. There is usually a reciprocal agreement between state associations to allow these to count for each state. If you have any questions, please ask your state association.

Full tuition is refunded immediately on request if the participant has not been sent the program materials and instructions. Once the instructions (including access codes) have been sent, a full refund will be issued only after the program runs and it is verified that the participant did not access the program.