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Catalog Number : ccma1068
Title : Chargemaster: Development for the ED and Provider-Based Clinics
Speaker : Duane Abbey

Duration : 90 minutes

Webplay Recording Date : 3-9-2016
Webplay Price : $ 150 for two weeks viewing

Target Audience:

  • Chargemaster Personnel
  • Compliance Personnel
  • Claims Transaction Personnel
  • Coding Personnel
  • All personnel involved with provider-based clinics and/or clinical operations including nursing staff and interested physicians

Webinar Objectives:

  • To review the Provider-Based Rule (PBR)
  • To understand the differences between freestanding and provider-based clinics
  • To understand the economic advantages of provider-based clinics
  • To appreciate special compliance concerns associated with provider-based status
  • To appreciate provider-based clinical services within the hospital
  • To delineate how the chargemaster should be established to support coding and billing for both technical and professional components
  • To discuss operation issues such as setting fees, patient relations and medical staff organizational structuring
  • To delineate the various types of clinics that can be provider-based
  • To appreciate organizing multiple provider-based clinics
  • To work through several case studies involving the establishment of the chargemaster

A few topics that will be discussed:

  • Review of the Provider-Based Rule (PBR)
    • Development of the PBR
    • 42 CFR §413.65
    • Review of Definitions
    • Rules and Regulations
    • Recognition by Non-Medicare Third-Party Payers
  • Economic Advantages of Provider-Based Status
    • Clinics
    • Clinical Services
    • Costs for Provider-Based Status
    • Recognizing Provider-Based Clinical Services
  • Establishing the Chargemaster
    • Technical Component - UB-04
    • Professional Component - 1500
    • Setting Fee Schedules
    • E/M Levels
    • Coding and Modifiers
  • Special Concerns
    • Maintaining Patient Relations
    • Medical Staff Organization
    • Meeting Other Provider-Based Rule Requirements
  • Special Types of Provider-Based Clinics
    • Wound Care Clinics
    • Specialty Clinics
    • Pain Management Clinics
    • Medication Management Clinics

Prerequisites for Participating:

General knowledge of hospitals and various clinic and/or clinical operations.

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.

Refund Policy:

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.