What Your Organization can do to Avoid the Risks. Jane Snecinski Post Acute Advisors, LLC P.O. Box Atlanta, GA

Jane Snecinski, FACHE Post Acute Advisors, LLC P.O. Box 12078 Atlanta, GA 30355 www.postacuteadvisors.com

Jane Snecinski, FACHE P.O. Box 12078 Atlanta, GA 30355 www.postacuteadvisors.com RAC Demonstration Project 3 year demonstration project Greatest impact to IRF from California Issue with greatest impact

Jane Snecinski Post Acute Advisors, LLC P.O. Box 12078 Atlanta, GA 30355 www.postacuteadvisors.com. RAC National Summit

Jane Snecinski P.O. Box 12078 Atlanta, GA 30355 www.postacuteadvisors.com RAC National Summit Inpatient Rehab Patients Not Meeting Medical Necessity Criteria Late Submissions of PAI Outpatient Therapy

How To Get A National Rac (And Mac)

7 th National RAC (and MAC) Summit December 5 6, 2012 Washington, DC Jane Snecinski P.O. Box 12078 Atlanta, GA 30355 www.postacuteadvisors.com National client base (both public and private sector) based

Recovery Auditors and Fee-for-Service Medicare DIVISION OF RECOVERY AUDIT OPERATIONS CENTERS FOR MEDICARE & MEDICAID SERVICES

Recovery Auditors and Fee-for-Service Medicare 1 DIVISION OF RECOVERY AUDIT OPERATIONS CENTERS FOR MEDICARE & MEDICAID SERVICES What is a Recovery Auditor? The Recovery Auditors are CMS contractors who

How to Successfully Appeal a RAC Audit. Kelly McCloskey Cherf Hogan Marren, Ltd.

How to Successfully Appeal a RAC Audit Kelly McCloskey Cherf Hogan Marren, Ltd. General Background RAC - Recovery Audit Contractor The Medicare Prescription Drug, Improvement, and Modernization Act (2003)

Recovery Audit Contractor Program

Recovery Audit Contractor Program What is a RAC? Recovery Audit Contractor RAC Mission Detect and correct past improper payments so that future improper payments can be prevented: Providers can avoid submitting

Exploring the Impact of the RAC Program on Hospitals Nationwide. Results of AHA RACTRAC Survey, 2 nd Quarter 2015

Exploring the Impact of the RAC Program on Hospitals Nationwide Results of AHA RACTRAC Survey, 2 nd Quarter 2015 September 10, 2015 RAC 101 Centers for Medicare & Medicaid Services (CMS) Recovery Audit

THE MEDICARE RECOVERY AUDIT CONTRACTOR (RAC) PROGRAM: An Evaluation of the 3-Year Demonstration

THE MEDICARE RECOVERY AUDIT CONTRACTOR (RAC) PROGRAM: An Evaluation of the 3-Year Demonstration June 2008 THE MEDICARE RECOVERY AUDIT CONTRACTOR (RAC) PROGRAM: An Evaluation of the 3-Year Demonstration

RAC Preparation 7 Key Steps and Best Practices

McGuireWoods Health Care practice is ranked 6th largest in the country by the American Health Lawyers Association. RAC Preparation 7 Key Steps and Best Practices Elissa K. Moore, Associate 704.343.2218

Recovery Audit Contractor (RAC) Program Review and Update

Recovery Audit Contractor (RAC) Program Review and Update S C O T T W A K E F I E L D P A T R I C I A R O S I N S K I A C A D E M Y O F M E D I C I N E O F C L E V E L A N D & N O R T H E R N O H I O DIVISION

Recovery Audit Contractors (RACs) and Medicare. The Who, What, When, Where, How and Why?

Recovery Audit Contractors (RACs) and Medicare The Who, What, When, Where, How and Why? 1 Agenda What is a RAC? Will the RACs affect me? Why RACs? What does a RAC do? What are the providers options? What

Recovery Audit Contractor Audits: What You Need to Know

Recovery Audit Contractor Audits: What You Need to Know August 19-21, 2009 Gulfport Hattiesburg Meridian Jackson Kosciusko Presented by: Jeff Moore Phelps Dunbar LLP jeff.moore@phelps.com Materials PowerPoint

Medicare s Recovery Audit Contractor (RAC) Program

Recovery Audit Contractor Update Medicare s Recovery Audit Contractor (RAC) Program HFMA Northern California Spring Conference Rudy Braccili Jr, MBA, CPAM Sr. Director, National Medicare & Medicaid Center

Audits: Know your risks and Get prepared

Objectives Audits: Know your risks and Get prepared 1. Establish familiarity with various audit contractors and identify variances in their audit processes 2. Understand documentation guidelines and requirements

Hospital Client Alert H EALTH M ANAGEMENT A SSOCIATES. January 2009 RAC A UDITS. HMA Team. RAC Overview

Hospital Client Alert January 2009 H EALTH M ANAGEMENT A SSOCIATES RAC A UDITS HMA Team Health Management Associates (HMA) has assembled an integrated team of financial, clinical, legal and administrative

Inpatient or Outpatient Only: Why Observation Has Lost Its Status

Inpatient or Outpatient Only: Why Observation Has Lost Its Status W h i t e p a p e r Proper patient status classification affects the clinical and financial success of hospitals. Unfortunately, assigning

Revenue Cycle Management Practice

Revenue Cycle Management Practice W h i t e p a p e r By William Malm, ND, RN Practice Director, Revenue Cycle Management, HCPro, Inc. Recovery audit contractors Recovery Audit Contractors Strategic planning

Home Health Billing Scenarios - DRAFT. Disclaimer

Home Health Billing Scenarios - DRAFT 1493_1013 Disclaimer National Government Services, Inc. has produced this material as an informational reference for providers furnishing services in our contract

Presented by: Anne B Mattson, RN, MSN. Teresa Mack. www.transpirus.com. Director Regulatory and Compliance. Director Revenue Cycle Management

Minimize Reimbursement Risks: Keys to Developing a Successful Compliance Audit Program for Billing Presented by: Anne B Mattson, RN, MSN Director Regulatory and Compliance Teresa Mack Director Revenue

Exploring the Impact of the RAC Program on Hospitals Nationwide. Results of AHA RACTRAC Survey, 4 th Quarter 2012

Exploring the Impact of the RAC Program on Hospitals Nationwide Results of AHA RACTRAC Survey, 4 th Quarter 2012 March 8, 2013 RAC 101 Centers for Medicare & Medicaid Services (CMS) Recovery Audit Contractors

Your Inpatient Rehabilitation Program in Shape? Current Compliance Issues

Your Inpatient Rehabilitation Program in Shape? Current Compliance Issues Presented by: Jane Snecinski, FACHE Principal Noblis Center for Health Innovation Tracy M. Field, Partner Life Sciences Practice

Common Medicare Billing Mistakes Systems and protocols necessary to help prevent and overpayment Best practices in resolving an overpayment

Bill J. Ulrich, President / CEO Consolidated Billing Services Inc. Pat Newberry, Director of Clinical Education AIS Inc. Common Medicare Billing Mistakes Systems and protocols necessary to help prevent

Claims Data: Source and Processing. Barbara Frank, M.S., M.P.H. Director of Workshops, Outreach, and Research University of Minnesota

Claims Data: Source and Processing Barbara Frank, M.S., M.P.H. Director of Workshops, Outreach, and Research University of Minnesota Overview of CMS Claims Data What is a claim? How are claims processed?

The Third National Medicare RAC Summit

The Third National Medicare RAC Summit Major Hospital Vulnerabilities II: Medical Necessity and Clinical Documentation Issues in Medicaid and RAC Audits Edmund L. Lafer, MD Temple University Health System

Revenue Cycle in Post- Acute Care Deloitte & Touche LLP Victor Shutack, Senior Manager June 2015

6/9/2015 Revenue Cycle in Post- Acute Care Deloitte & Touche LLP Victor Shutack, Senior Manager June 2015 Discussion topics Changing healthcare environment Understanding the home health care environment

2/21/2014. Therapy Utilization in Long Term Care: Is It Really Over Utilization

Therapy Utilization in Long Term Care: Is It Really Over Utilization Shawn Halcsik DPT, MEd, OCS, RAC CT, CPC, CHC Vice President of Compliance Evergreen Rehabilitation Judith Bartlett Program Analyst

Critical Access Hospital (CAH) and CAH Swingbed Questions and Answers

Critical Access Hospital (CAH) and CAH Swingbed Questions and Answers The following questions and answers are from the April 2012 CAH and CAH Swingbed web-based trainings: Q1. Is a non-covered/no pay bill

The Official Guidelines for coding and reporting using ICD-9-CM

Reporting Accurate Codes In the Era of Recovery Audit Contractor Reviews Sue Roehl, RHIT, CCS The Official Guidelines for coding and reporting using ICD-9-CM A set of rules that have been developed to

Preparing for Medicare s Recovery Audit Contractor (RAC) Permanent Program: Are you ready?

Preparing for Medicare s Recovery Audit Contractor (RAC) Permanent Program: Are you ready? Presentation topics Premier Consulting Solutions (PCS) Background RevenueConnect RAC Overview The Demonstration

Be on Target, Not a Target: Surviving the Ongoing Focus on Medical Necessity and Short Stays

Be on Target, Not a Target: Surviving the Ongoing Focus on Medical Necessity and Short Stays UT Systemwide Compliance Academy March 27, 2013 Deloitte & Touche LLP Presenters: Kelly Sauders, Partner John

MEDICARE RECOVERY AUDIT CONTRACTORS AND CMS S ACTIONS TO ADDRESS IMPROPER PAYMENTS, REFERRALS OF POTENTIAL FRAUD, AND PERFORMANCE

Department of Health and Human Services OFFICE OF INSPECTOR GENERAL MEDICARE RECOVERY AUDIT CONTRACTORS AND CMS S ACTIONS TO ADDRESS IMPROPER PAYMENTS, REFERRALS OF POTENTIAL FRAUD, AND PERFORMANCE Daniel

The Audit Landscape: MICs, MACs, RACs and ZPICs

The Audit Landscape: MICs, MACs, RACs and ZPICs Andrew B. Wachler Wachler & Associates, P.C. 210 E. Third St., Suite 204 Royal Oak, MI 48067 248 544 0888 awachler@wachler.com HCAM/MCAL Annual Convention

What to know if Medicare denies coverage

What to know if Medicare denies coverage What Medicare covers Necessary post-hospital extended care for up to 100 days Extended care: nursing care and rehab provided to a Medicare beneficiary who is an

Statement of Work for the Recovery Audit Program

I. Purpose Statement of Work for the Recovery Audit Program The Recovery Audit Program s mission is to reduce Medicare improper payments through the efficient detection and collection of overpayments,

How to Prepare a Winning RAC Appeal

How to Prepare a Winning RAC Appeal Craneware InSight Consulting Copyright 2011, CRANEWARE INSIGHT. All rights reserved. www.cranewareinsight.com p.1 Introduction Introductions Karen Bowden, RHIA, Senior

Network PlatinumPlusMedicare Supplement Plans - Changes to Medicare Coverage in 2016

Network PlatinumPlus (PPO) offered by Network Health Insurance Corporation Annual Notice of Changes for 2016 You are currently enrolled as a member of Network PlatinumPlus. Next year, there will be some

EHR Client Bulletin: Answers to Your Most Frequently Asked Condition Code 44 Questions

EHR Client Bulletin: Answers to Your Most Frequently Asked Condition Code 44 Questions Originally Issued On: February 25, 2010 Last Update: February 20, 2013 UPDATE: The following EHR Client Bulletin was

CMS Response to the Hurricane Emergency. Questions and Answers About Medicare Fee-For-Service

CMS Response to the Hurricane Emergency Questions and s About Medicare Fee-For-Service # Question and Waiver of Certain Medicare Requirements 1 Question: Do the modifications and flexibilities described

Documentation: Now More Than Ever, Your Reimbursement Depends On It

Improving Your Documentation : Know What Is Expected By Medicare Or What We Could Have Titled: Documentation: Now More Than Ever, Your Reimbursement Depends On It Rhonda Lane, LOTR Objectives Participants

Medicare Outpatient Therapy Billing

DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services R Medicare Outpatient Therapy Billing August 2010 / ICN: 903663 DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare

Audit Management Solutions Overview. Wednesday, January 8, 2014 By Dawn Crump, MA, CHC, SSBB VP of Audit Management Solutions

Audit Management Solutions Overview Wednesday, January 8, 2014 By Dawn Crump, MA, CHC, SSBB VP of Audit Management Solutions Agenda Auditor Overview Audit Impact Importance of AudaPro to the Client Financial

ZPIC, RAC and MAC Audits Proactive vs. Reactive Approach

YOUR DATES HERE YOUR LOGO HERE ZPIC, RAC and MAC Audits Proactive vs. Reactive Approach Lisa Thomson, Vice President Pathway Health 877-777-5463 www.pathwayhealth.com YOUR LOGO HERE OBJECTIVES Understand

Medicare, Medicaid & Third Party Payer Audits: Latest Developments & Emerging glegal Issues Affecting Home Health and Hospice Providers

Medicare, Medicaid & Third Party Payer Audits: Latest Developments & Emerging glegal Issues Affecting Home Health and Hospice Providers Andrew B. Wachler Wachler & Associates, P.C. 210 E. Third St., Suite

ANNUAL NOTICE OF CHANGES FOR 2016

Cigna-HealthSpring Preferred (HMO) offered by Cigna-HealthSpring ANNUAL NOTICE OF CHANGES FOR 2016 You are currently enrolled as a member of Cigna-HealthSpring Preferred (HMO). Next year, there will be

CHANGING YOUR CASE MANAGEMENT MODEL OF CARE. Jan Lear, RN, CMC Director of Case Management MedStar Franklin Square Medical Center

CHANGING YOUR CASE MANAGEMENT MODEL OF CARE Jan Lear, RN, CMC Director of Case Management MedStar Franklin Square Medical Center 1 Program Objectives To be able to describe the compliance and regulatory

September 4, 2012. Submitted Electronically

September 4, 2012 Ms. Marilyn Tavenner Acting Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-1589-P P.O. Box 8016 Baltimore, MD 21244-8016

How To Decide If A Hospital Transportation Service Is Separately Reimbursed For A Patient

CMS Referral for Own Motion Review by DAB/MAC Appellant at ALJ Level Hart to Heart Ambulance Service, Inc. ALJ Appeal Number 1-784906086 Beneficiary (if not the Appellant) List attached ALJ Decision Date

Unit 1 Core Care Management Activities

Unit 1 Core Care Management Activities Healthcare Management Services Healthcare Management Services (HMS) is responsible for all the medical management services provided to Highmark Blue Shield members,

Session 303 How to Use Scorecards to Manage Revenue Cycle Compliance

Session 303 Manage Revenue Cycle Compliance M. Aaron Little, CPA CPAs & ADVISORS BKD, LLP Managing Director mlittle@bkd.com Patrick Brown, MBA, MS Penn Home Care & Hospice Services Chief Financial Officer

New Outpatient Therapy Evaluation and Intervention E&I Codes. An introduction to the new policy and new claims coding requirements

New Outpatient Therapy Evaluation and Intervention E&I Codes An introduction to the new policy and new claims coding requirements Disclaimer Contents of this presentation are for educational purposes only.

Original Medicare: An Outline of Benefits Prepared for the Alzheimer's Association

Someone to 51and hy You Original Medicare: An Outline of Benefits Prepared for the Alzheimer's Association Medicare is a federal health insurance program designed to provide affordable health insurance

Strategic Approaches to Challenging Inpatient-Outpatient Denials at the ALJ Hearing

Strategic Approaches to Challenging Inpatient-Outpatient Denials at the ALJ Hearing Andrew B. Wachler Wachler & Associates, P.C. 210 E. Third St., Ste. 204 Royal Oak, MI 48067 (248) 544-0888 awachler@wachler.com

Medicare Recovery Audit Contractors

RAC Questions & Answers What is CMS s expansion schedule for the nationwide RAC program? Who will serve as contractors for the nationwide RAC program? Whose claims can be reviewed by the RAC? Aren t RACs

WEBINAR COLLABORATE WITH PLANTE & MORAN EXPERTS: RAC CRISIS CONTROL TIMES. plantemoran.com

WEBINAR COLLABORATE WITH PLANTE & MORAN EXPERTS: RAC CRISIS CONTROL TIMES TOPICS4THET plantemoran.com February 25, 2010 GETTING STARTED RAC CRISIS CONTROL WEBINAR Today s session begins at 2 p.m. Eastern

The following references are used throughout the billing scenarios that follow:

11 Part B Billing Scenarios for PTs and OTs The following billing scenarios formerly appeared on the Frequently Asked Questions (FAQ) website and on the Therapy Medlearn website as "11 FAQs" - posted 9/13/02

R. Kendall Smith, Jr., MD, SFHM. 601 NW 22 nd Court Wilton Manors, FL 33311 Phone: (954) 610-381

601 NW 22 nd Court Wilton Manors, FL 33311 Phone: (954) 610-381 PROFESSIONAL SUMMARY I am a hospitalist of 18 years with an extensive background in quality improvement, utilization review, information

MEDICARE COMPLIANCE REVIEW OF UNIVERSITY OF CINCINNATI MEDICAL CENTER

Department of Health and Human Services OFFICE OF INSPECTOR GENERAL MEDICARE COMPLIANCE REVIEW OF UNIVERSITY OF CINCINNATI MEDICAL CENTER FOR CALENDAR YEARS 2010 AND 2011 Inquiries about this report may

Inquiries, Reopenings, & Appeals Chapter 13

Chapter 13 Contents 1. Telephone Inquiries 2. Written Inquiries 3. mycgs The Jurisdiction C Web Portal 4. Provider Outreach and Education (POE) Department 5. Reopenings for Minor Errors and Omissions 6.

ANNUAL NOTICE OF CHANGES FOR 2016

Cigna-HealthSpring Preferred (HMO) offered by Cigna-HealthSpring ANNUAL NOTICE OF CHANGES FOR 2016 You are currently enrolled as a member of Cigna-HealthSpring Preferred (HMO). Next year, there will be

Regulatory Compliance Policy No. COMP-RCC 4.07 Title:

I. SCOPE: Regulatory Compliance Policy No. COMP-RCC 4.07 Page: 1 of 7 This policy applies to (1) any Hospital in which Tenet Healthcare Corporation or an affiliate owns a direct or indirect equity interest

Recovery Audit Contractor (RAC) Toolkit

Recovery Audit Contractor (RAC) Toolkit American Health Information Management Association 2009 Recovery Audit Contractor (RAC) Toolkit 2009 AHIMA Page 1 of 65 Table of Contents Foreword.4 Authors...4

Coverage Basics. Your Guide to Understanding Medicare and Medicaid

Coverage Basics Your Guide to Understanding Medicare and Medicaid Understanding your Medicare or Medicaid coverage can be one of the most challenging and sometimes confusing aspects of planning your stay

Recovery Auditing in the Medicare and Medicaid Programs for Fiscal Year 2011

ems Recovery Auditing in the Medicare and Medicaid Programs for Fiscal Year 2011 FY 2011 Report to Congress as Required by Section 1893(h) of the Social Security Act for Medicare and Section 6411c of the

Exploring the Impact of the RAC Program on Hospitals Nationwide. Results of AHA RACTRAC Survey, 2 nd Quarter 2012

Exploring the Impact of the RAC Program on Hospitals Nationwide Results of AHA RACTRAC Survey, 2 nd Quarter 2012 August 22, 2012 RAC 101 Centers for Medicare & Medicaid Services (CMS) Recovery Audit Contractors

CHAPTER 7: UTILIZATION MANAGEMENT

OVERVIEW The Plan s Utilization Management (UM) program is collaboration with providers to promote and document the appropriate use of health care resources. The program reflects the most current utilization

INTRODUCTION BACKGROUND Skilled Nursing Facilities A SNF is an institution primarily engaged in providing skilled nursing care and related services to residents who require medical or nursing care and

CENTERS FOR MEDICARE & MEDICAID SERVICES. Medicare Appeals

CENTERS FOR MEDICARE & MEDICAID SERVICES Medicare Appeals This official government booklet has important information about: How to file an appeal if you have Original Medicare How to file an appeal if

Inpatient Transfers, Discharges and Readmissions July 19, 2012

Inpatient Transfers, Discharges and Readmissions July 19, 2012 Discharge Status Codes Two-digit code Identifies where the patient is at conclusion of encounter Visit Inpatient stay End of billing cycle

How To Reduce Hospital Readmission

Reducing Hospital Readmissions & The Affordable Care Act The Game Has Changed Drastically Reducing MSPB Measures Chuck Bongiovanni, MSW, MBA, NCRP, CSA, CFE Chuck Bongiovanni, MSW, MBA, NCRP, CSA, CFE

Medicare Program Integrity Manual

Medicare Program Integrity Manual Chapter 3 - Verifying Potential Errors and Taking Corrective Actions Transmittals for Chapter 3 Table of Contents (Rev. 608, 08-14-15) 3.1 - Introduction 3.2 - Overview

Fraud and Abuse: Part 1

Fraud and Abuse: Part 1 This article was developed from a presentation by Gayle Lee, J.D., Senior Director of Health Finance and Quality for the American Physical Therapy Association, at the 2013 FSBPT

Basic Medical Record Documentation

Basic Medical Record Documentation Presented by Cahaba Government Benefit Administrators, LLC P rovider O u t reach and Education September 19, 2013 1 Disclaimers This resource is not a legal document.

Medicare Post Payment Claim Audits (RACs, ZPICs, and Other Tools)

Medicare Post Payment Claim Audits (RACs, ZPICs, and Other Tools) AHLA Long Term Care and the Law Program Feb 20-22, 2014 Presented by: Brian Daucher Esq. Sheppard Mullin Richter & Hampton LLP Claudia

I N T HIS I SSUE HEALTH LAW PERSPECTIVES. What Medicare Providers Should Know About the OIG Work Plan for Fiscal Year 2008.

Celebrating 20 YEARS of excellence HEALTH LAW PERSPECTIVES Newsletter Volume 10, No. 1 What Medicare Providers Should Know About the OIG Work Plan for Fiscal Year 2008 By Abigail Wong January 2008 On October

Georgia Physician Medical Record/Recovery Audit Contractors

Georgia Physician Medical Record/Recovery Audit Contractors Auditors Name/Purpose Legal Basis Review Process Record Request Limit/Time Period Audit Time Line Actions You Can Take Medicare RAC-Connolly

The Real Cost of the Inefficient Medicare RAC Program

HOSPITAL SURVEY REPORT: The Real Cost of the Inefficient Medicare RAC Program The Recovery Audit Contractor (RAC) program was created by Congress to audit providers Medicare claims to identify overpayments

The Recovery Audit Contractor Program: What Every Physical Therapist Needs to Know!

The Recovery Audit Contractor Program: What Every Physical Therapist Needs to Know! Physical therapists and providers of physical therapy services in California, Florida, and New York are targets of a

Medicare Policy Regarding Pressure Reducing Support Surfaces JA1014

Medicare Policy Regarding Pressure Reducing Support Surfaces JA1014 Note: JA1014 was revised and re-issued in its entirety. Related CR Release Date: N/A Date Job Aid Revised: August 24, 2010 Effective

All In! Strategies for Rehab Providers in Tomorrow s Reality NARA Fall Conference 2015 The Westin Las Vegas ~ October 14 16, 2015

Wednesday, October 14 th 8:30 9:00am Registration Light breakfast buffet 9:00 9:45am Conference Welcome Stephen Hunter, NARA President 9:45 11:45am Don t Gamble Away Your Future Payments - Know How CPT

At a Glance. MedHelp, Inc. S Third-Party--Payor News. Who Are We. Services. MedHelp, Inc. Benefits. Contact Us

MedHelp brings you a dynamic news outlet designed to break the barriers between Third-Party-Payors and the Facilities and! Breaking News from the Source to You CMS Recovery Audit Contractor FAQs (Information

Update: Medical Necessity Documentation. Kerry Dunning, MHA, MSH, CPAR, RAC-CT GPS HEALTHCARE CONSULTANTS November 2013

Update: Medical Necessity Documentation Kerry Dunning, MHA, MSH, CPAR, RAC-CT GPS HEALTHCARE CONSULTANTS November 2013 REMINDER Many claim denials occur because the providers or suppliers do not submit

Figuring Out the Codes: Inpatient Rehabilitation Facilities and the Transfer Policy

Figuring Out the Codes: Inpatient Rehabilitation Facilities and the Transfer Policy Inpatient rehabilitation facilities (IRFs) are hospitals (or subunits of a hospital) that offer intensive rehabilitation

T- 09 Up Up and Away with Mediocre Therapy Documentation

T- 09 Up Up and Away with Mediocre Therapy Documentation Carol Ashdown M. A. CCC-SLP RAC-CT CHC Carol Ashdown is a Regional Vice President of Consulting for Exponential Consulting Services specializing

Regulatory Updates for Outpatient Rehab + Documentation Audit - Next Steps

Regulatory Updates for Outpatient Rehab + Documentation Audit - Next Steps P.J. Rhoades PT, DPT, MS, CHC Director of Compliance and Denials Management Objectives Discuss changes in regulation for outpatient

Chapter 4 Health Care Management Unit 1: Care Management

Chapter 4 Health Care Unit 1: Care In This Unit Topic See Page Unit 1: Care Care 2 6 Emergency 7 4.1 Care Healthcare Healthcare (HMS), Highmark Blue Shield s medical management division, is responsible

BILLING FOR AND APPEALING DENIALS OF INPATIENT HOSPITAL SERVICES Where have we been? Where are we now? What does the future hold?

ABA Health Lawyer December 2013 IN THIS ISSUE Billing for and Appealing Denials of Inpatient Hospital Services... 1 Chair s Column... 2 Section News... 25 Patient Protection and Affordable Care Act Could

Postacute Care Transfer Rule Review. HFMA Northern California COMPLIANCE WEBINAR SERIES California Statewide Webinar February 2012.

Postacute Care Transfer Rule Review HFMA Northern California COMPLIANCE WEBINAR SERIES California Statewide Webinar February 2012 Speaker Gloryanne Bryant, RHIA, RHIT, CCS, CCDS Regional Managing Director

Recovery Audit Contractors (RACs) and Medicare The Who, What, When, Where, Why and How?

Recovery Audit Contractors (RACs) and Medicare The Who, What, When, Where, Why and How? Eileen Turner Acting Associate Regional Administrator Centers for Medicare & Medicaid Services San Francisco Regional

National Correct Coding Initiative Policy Manual for Medicare Services Revision Date: January 1, 2014

National Correct Coding Initiative Policy Manual for Medicare Services Revision Date: January 1, 2014 Current Procedural Terminology 2013 American Medical Association. All Rights Reserved. Current Procedural

HCCA 14 th Annual Compliance Institute April 18-21, 2010 Dallas, Texas

HCCA 14 th Annual Compliance Institute April 18-21, 2010 Dallas, Texas Revenue Integrity and Safeguarding: Comprehensive Strategies for Contractor Combat (RACs, MICs, ZPICs and Others) Today s Speakers

Place of Service Codes

Place of Service Codes Code(s) Place of Service Name Place of Service Description 01 Pharmacy** A facility or location where drugs and other medically related items and services are sold, dispensed, or

Provider Type. Date Approved. Services (Physician/ Non- Physician Practitioner) Services (Physician/ Non-Physician Practitioner)

: HealthataInsights Alaska, Arizona, California, Hawaii, Iowa, Idaho, Kansas, Missouri, Montana, North akota, Nebraska, Nevada, Oregon, South akota, Utah, Washington, Wyoming, Guam, American Samoa and

Sunshine Act reporting: Minimizing consulting and royalty payment risks. Stephanie J. Kravetz

Compliance TODAY October 2013 a publication of the health care compliance association www.hcca-info.org Why compliance matters to the enforcement community Loretta Lynch U.S. Attorney, Eastern District

Summary of Anti-Fraud Provisions in the Affordable Care Act

Summary of Anti-Fraud Provisions in the Affordable Care Act Michael F. Ruggio Shareholder Patrick J. Hurd Senior Counsel Sarah Reimers McIntee Associate Before we begin... Reminder that phone lines are

Basics of Skilled Nursing Facility Consolidated Billing (SNF-CB) Medicare Part A and B Presentation March 19, 2013

Basics of Skilled Nursing Facility Consolidated Billing (SNF-CB) Medicare Part A and B Presentation March 19, 2013 2 Agenda Skilled Care Defined Background on SNF-CB Under Arrangements Inclusions and Exclusions

BCN65 NONGROUP COVERAGE DISCLOSURES

BCN65 NONGROUP COVERAGE DISCLOSURES BCN65 is not a supplemental product. It is not designed to fit with. It may not fit all of the gaps in and it may duplicate some benefits. If you are eligible for, review

UNRAVELING THE MYSTERY OF INSURANCE AUDITS. Deborah J. Winegard Of Counsel Whatley Kallas, LLP

UNRAVELING THE MYSTERY OF INSURANCE AUDITS Deborah J. Winegard Of Counsel Whatley Kallas, LLP 1 PHYSICIANS ADVOCACY INSTITUTE PAI Founded in 2006 as Result of MDL Managed Care Litigation, in which MSNJ

The Role of the Recovery Audit Contractor

The Role of the Recovery Audit Contractor Presented by: Franco Signor LLC Brought to you by: Alliance Collection Services, Inc. 6404 Manatee Avenue West, Suite N, Bradenton FL 34209 / 888-959-0692 / www.francosignor.com

Regulatory Compliance Policy No. COMP-RCC 4.52 Title:

I. SCOPE: Regulatory Compliance Policy No. COMP-RCC 4.52 Page: 1 of 19 This policy applies to (1) Tenet Healthcare Corporation and its wholly-owned subsidiaries and affiliates (each, an Affiliate ); (2)