Catalog Number : cca1914
Title : APCs: Auditing for Compliance
Speaker : Duane Abbey

Webplay Recording Date : 6-12-2014
Webplay Price : $ 125 for two weeks viewing

Webinar Overview: 

What are the main components and features of APCs? What should we do if there are challenges or problems encountered through an APC audit? What are the issues within APCs that should be considered for possible review? To answer these questions and more, come join us at this informational Webinar.

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
• Appreciate why reimbursement tracking is important for APCs
• Appreciate that conducting APC audits can become quite complex
• Understand the need for competent reviews and auditors so that all the various issues with APCs can be considered
• Understand APC issues that may be addressed in the RAC (Recovery Audit Contractor) program

Target Audience: 

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

Webinar Overview:

• 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
  • Proper Coding, Billing and Claims Flow
  • RAC Audit Issues
• APC Audit Process
  • Selection of Cases
  • Stratification
  • Review Process
  • Reports and Recommendations

Contact Hours:

• All participants: Must attend the entire Webinar and complete a Webinar critique to receive a 1.5 Hour Attendance Certificate for each program. Completion of offering required prior to awarding certificate.

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.