Catalog Number : cra1072
Title : Coding & Billing for Provider-based Clinics
Speaker : Duane Abbey

Duration : 90 minutes

Webplay Recording Date : 5-13-2009
Webplay Price : $ 225 for two weeks viewing

Target Audience:

Chargemaster personnel, compliance personnel, claims transaction personnel, coding personnel, and all personnel involved with provider-based clinics and/or clinical operations including nursing staff and interested physicians.

Prerequisites for Participating:

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

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 discuss coding and billing issues for provider-based clinics
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

Webinar Outline/Agenda:

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
Coding and Billing
- Technical Component E/M Coding
- Surgical Services Coding
- Medical Services Coding
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

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.

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