Catalog Number : cra1635
Title : Provider-Based Rule Update for 2017
Speaker : Duane Abbey

Webplay Recording Date : 1-19-2017
Webplay Price : $ 150 for two weeks viewing

Webinar Overview:

The Provider-Based Rule (PBR) is complex and sometimes ambiguous. Recent changes in the supervisory requirements for provider-based operations have created confusion and new compliance challenges. In this workshop the overall purpose and function of the provider-based rule is addressed as well as critical information concerning physician supervisory changes. Also, the various criteria that hospitals must achieve in order to gain the benefits from provider-based status will be reviewed. Exercises and case studies will be included.

Target Audience:

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

Webinar Objectives:

• Review the Provider-Based Rule (PBR) and recognize areas of ambiguity with the PBR
• Discuss documentation requirements relative to physician supervision requirements
• Differentiate the different areas in which the PBR applies
• Recognize the attestation and request for determination processes
• Recognize the need for updating and the documentation of organizational structuring relative to the PBR
• Recognize the review process for assessing current and/or potential provider-based situations
• Compare the economic benefits versus the compliance requirements
• Examine the relationship of PBR relative to the Conditions for Payment, Conditions of Participation and gaining billing privileges

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
  • Recognition by Non-Medicare Third-Party Payers
• Problem Areas Within the PBR
  • Under Arrangements
  • Management Contracts
  • Geographic Proximity
  • Signage and Identification
  • Establishing PBR Clinic Fee Schedules
• Economic Advantages of Provider-Based Status
  • Clinics
  • Clinical Services
  • Costs for Provider-Based Status
• 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

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.