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Catalog Number : cra1617
Title : Critical Access Hospitals: Provider-Based Clinics
Speaker : Duane Abbey

Duration : 90 minutes

Webplay Recording Date : 6-9-2011
Webplay Price : $ 200 for two weeks viewing

Webinar Overview:

CAHs are considered to be hospitals within the provider-based rule (PBR). In this webinar, the overall purpose and function of the provider-based rule relative to provider-based clinics is addressed as well as critical information concerning physician supervisory changes. CMS has recently made significant changes in the interpretation of physician supervision for on-campus (out of hospital) provider-based operations. Additionally, the overall compliance issues surrounding provider-based clinics and provider-based status will also be discussed.

Webinar Level: Advanced

Prerequisites for Participating:

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

Target Audience:

  • All personnel involved with provider-based clinic and/or clinical operations
  • compliance personnel
  • interested practitioners and physicians are encouraged to attend

Webinar Objectives:

  • To review the Provider-Based Rule (PBR)
  • To discuss CAHs involvement under the PBR
  • To recognize the advantages of provider-based clinics
  • To review critical physician supervisory rule changes
  • To examine the different areas in which the PBR applies
  • To discuss the attestation and request for determination processes
  • To recognize the need for updating and the documentation of organizational structuring relative to the PBR
  • To explain the review process for assessing current and/or potential provider-based situations
  • To discuss the differences between hospital-based clinics and Rural Health Clinics (RHCs) in light of the PBR
  • To review several case studies

A few of the Topics that will be covered:

  • Review of the Provider-Based Rule (PBR)
    • Development of the PBR
    • 42 CFR §413.65
    • Review of Definitions
    • Rules and Regulations
    • Involvement of CAHs
    • Recognition by Non-Medicare Third-Party Payers
  • Economic Advantages of Provider-Based Status
    • Clinics
    • Clinical Services
    • Provider-Based Clinics vs. RHCs
  • Physician Supervisory Requirements
    • Recent Changes and Clarifications
    • In-Hospital
    • On-Campus
    • Off-Campus
    • Possible Recovery Audit Contractor (RAC) Issues
  • Compliance and Obligations Under PBR
    • Meeting All PBR Criteria
    • Reporting Requirements
    • Attestation versus Determination Process
  • Related Issues
    • Conditions for Payment
    • Conditions of Participation
    • Other Third-Party Payer Relations
    • Coding and Billing for Provider-Based Clinics
  • Case Studies - Provider-Based Clinics and RHCs

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.