Catalog Number : cga1733
Title : Mastering the DRG 3-day Payment Window
Speaker : Duane Abbey

Webplay Recording Date : 3-28-2013
Webplay Price : $ 200 for two weeks viewing

Webinar Overview:

What is the purpose of the 3-Day Payment Window? How do we know what services are related to admission? Is there an equivalent post-discharge window? To answer these questions and more come join us in this important and educational Webinar.

Target Audience:

• Patient Financial Services Personnel
• Business Office Staff
• Compliance Personnel
• Financial Analysts
• Information Technology Personnel
• Health Information Coding Staff
• Interested Clinical Personnel

Webinar Objectives:

• To review the concept of the 3-Day Payment Window
• To discuss the associated 1-Day Window for special hospitals
• To assess the changes made to the Social Security Act (SSA) as of June 25, 2010
• To review associated Federal Register entries
• To review the concept of determining related therapeutic services under the window
• To discuss operational concerns for properly applying the window
• To discuss the ‘wholly owned or wholly operated’ trigger for the window
• To appreciate how provider-based status affects the window
• To explain how physician billing and reimbursement is affected at hospital owned freestanding clinics under the 3-day window
• To understand how the OIG views the 3-Day Payment Window
• To appreciate how MS-DRG grouping can be affected by the inclusion of outpatient services in the window
• To recognize proper actions when an inpatient admission is not medically necessary and there are services in the window
• To work through several case studies

Webinar Topics:

• Review of the 3-Day Payment Window
  • Bundling Outpatient Services into Inpatient Billing
  • Diagnostic vs. Therapeutic
  • Related Services
  • Wholly Owned or Wholly Operated
  • 3-Day Window vs. 1-Day Window
• Changes to the SSA Language
  • Change to §1886(a)(4)
  • Interpretation of Changed Language
  • Federal Register Discussions
• Concept of Related Diagnostic Services
  • Formula Prior to June 25, 2010
  • Guidance for Definitions After June 25, 2010
  • Operational Implications for Meeting the New Requirements
• Hospital Owned or Operated Freestanding Clinics
  • 3-Day Window Impact on Physician Billing and Reimbursement Under the MPFS
  • Physician Incident-To Billing Impact
  • Compliance Responsibilities
• Additional Considerations
  • Inpatient Admission Denials and the 3-Day Window
  • OIG Pronouncements
  • MS-DRG Implications
  • Application to Critical Access Hospitals (CAHs)
  • Provider-Based Status Implications
• Action Steps to Maintain Compliance
• Case Studies

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.

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.