Catalog Number : cca1846
Title : Conducting Outpatient Compliance Audits
Speaker : Duane Abbey

Webplay Recording Date : 8-28-2013
Webplay Price : $ 200 for two weeks viewing

Webinar Overview:

What can we do to protect ourselves? How can we prepare for future compliance issues surrounding APCs? What are the major compliance risks for APCs? Come join us for our Webinar to discuss these important questions.

Target Audience:

Outpatient Coding Personnel, Coding, Billing and Claims Transaction Personnel, Internal Auditing Personnel, Financial and Compliance Personnel, Physicians and other interested personnel

Webinar Objectives:

• Briefly 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

A few of the Topics that will be covered:

• 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 Development Concerns
• 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
• PT/OT and Other Outpatient Areas

Attendance Certificate:

• Must attend the entire Webinar and complete a Webinar critique to receive a 1.5 Hour Attendance Certificate for each program.

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.