HCPro Advancing CDI Boot Camp June 8-11, 2015

Transcription

1 HCPro Advancing CDI Boot Camp June 8-11, 2015 Metropolitan Chicago Healthcare Council 222 South Riverside Plaza (SE Corner of Canal & Adams Streets) 19th Floor Conference Center Co-hosted by PROGRAM OVERVIEW This intensive, four-day course will provide hospital clinical documentation improvement professionals and quality managers, as well as utilization review, revenue cycle, and compliance staff, with the tools needed to expand CDI efforts beyond traditional MS-DRG reviews to reflect the full scope of hospital services and to provide meaningful data as quality and payment become increasingly aligned. Detailed, high-quality documentation that provides an accurate clinical picture is not only key to protecting reimbursement under Medicare s quality and performance reporting initiatives, such as the Hospital Readmission Reduction Program, but is essential for supporting Medicare claims and preventing denials. Expert faculty will explain how documentation and code assignment affect the revenue cycle and how quality metrics relate to and impact reimbursement. Through a combination of lecture, class discussion, and hands-on exercises, attendees will gain an in-depth understanding of Medicare s complex inpatient and outpatient payment systems, as well as Hierarchical Condition Categories, the relationship between coded data and medical necessity denials, and the impact of documentation and coding on quality measures and reimbursement. A complete course outline, as well as a list of available continuing education credits for coders, CDI specialists, nurses, case managers, and physicians, may be found on pages 4-6 of this brochure. WHO SHOULD PARTICIPATE This program is designed for hospital CDI specialists and managers, health information management professionals, and quality managers, as well as utilization review directors and physician advisors. Compliance officers and revenue cycle management staff will also benefit from this course. FACULTY Laurie Prescott RN, MSN, CCDS, CDIP, AHIMA Approved ICD-10-CM/PCS Trainer is a Clinical Documentation Improvement Education Specialist with HCPro, a division of BLR. Prescott serves as a full-time instructor for the CDI Boot Camps as well as a subject matter expert for the Association of Clinical Documentation Improvement. Prescott is a frequent speaker on HCPro/ACDIS webinars and the author of The CDI Specialist s Complete Training Guide. Prescott started her nursing career in 1985 as a graduate of the University of Vermont School of Nursing. Since that time, she has worked at a variety of organizations including academic and large and small

2 community hospitals. She has worked in a number of clinical nursing roles, including medical/surgical, ICU, PACU and Endoscopy, as well as in management roles as director of medical/surgical and ICU and a compliance officer. She completed her MSN with a focus in nursing education at the University of Phoenix and has taught nursing as an adjunct instructor in an ADN nursing program. She continued to focus on nursing education as the director of Education at Danville Regional Medical Center. In 2007, Prescott left this role to develop and implement a CDI program at Morehead Memorial Hospital, where she remained prior to joining HCPro in August of DATES AND TIMES Registration and a continental breakfast will begin daily at 7:30 a.m. Lunch is included and provided onsite. Monday, June 8: Tuesday, June 9: Wednesday, June 10: Thursday, June 11: LOCATION MCHC is located in the building that is bordered by Adams Street on the north, Jackson Street on the south, Canal Street on the west, and the Chicago River on the east. The main entrance to our building, Fifth Third Center, faces Adams Street. Ample public parking is available, with the closest lot being the Union Station Self-Park, 320 S. Canal, which has entrances on Canal and Clinton. The Council is adjacent to Union Station and directly over the tracks (from Union Station tracks, come up the escalator towards Canal Street, around the staircase to the lobby, and take the elevator to the 19th floor), two blocks south of the Northwestern Station (Metra Ogilvie Transportation Center), and easy access from CTA bus and L stops. Please note: The management of MCHC s headquarters building has instituted enhanced security measures for the safety of all staff and visitors. Please allow extra time prior to the scheduled start of the program to obtain a visitor s badge at the security desk in the lobby. REGISTRATION AND FEES Advanced registration and payment by check or credit card are required, and registrations will not be confirmed until payment is received. Please note that invoicing is not available for this program. This class is offered in a small classroom setting, and both minimum and maximum enrollments apply. The same person is expected to attend all four days. Please reserve your place no later than Friday, April 10, Fees are per registrant and include daily continental breakfast, lunch, afternoon snacks, and all program materials. Fee MCHC Members: $ 1,495 Non-Members: $ 1,545 2

3 REGISTRATION INSTRUCTIONS Register Online (NEW): Please follow the steps below to register online using Zap Event, MCHC s new online registration platform. OR 1. Visit and select the seminar from the program listing. 2. Select Register Now to be taken to Zap Event s secure registration page. 3. You may choose to register as a guest or create an account with Zap Event. Creating an account will allow you to quickly register for all future MCHC events. (NOTE: This is a separate account from your online MCHC account; your MCHC username and password will not work on the Zap Event site.) 4. Enter the required registration fields, choose your payment method (check or credit card), and submit your registration. 5. You will receive a confirmation from Zap Event immediately upon registration. If paying by check, please follow the submission instructions included in the Zap Event confirmation. Registration will not be confirmed until the check is received by MCHC. Register by Fax: Complete the enclosed registration form and fax or it to Helena Lefkow at , [email protected]. If paying by check, please follow the submission instructions included on the registration form. Registration will not be confirmed until the check is received by MCHC. Cancellation Policy: Written notice of cancellation may be made via to Helena Lefkow at [email protected]. A $50 service charge applies to any refund of registration fees. Cancellations will be accepted and refunds issued for requests received by April 10, After April 10, 2015, cancellations will be accepted and refunds issued only if there is a waiting list for the class and another paid registrant is available. Substitutions may be made at any time, and we appreciate being informed of any name changes in advance of the program. Special Requests: MCHC will make every effort to fulfill special requests for accommodations made at the time of advanced registration. Please direct any requests to Helena Lefkow at [email protected]. ADDITIONAL INFORMATION For questions about registration and payment, please contact Donna Wallace, support and training specialist, at MCHC at , [email protected]. Questions about program content may be directed to Helena Lefkow, program manager, Patient Financial Services, at , [email protected]. 3

4 COURSE OUTLINE Monday, June 8 Introduction to Healthcare Data o Uniform Hospital Discharge Data Set (UHDDS) key definitions and elements by setting Code Sets o HIPAA Administrative Simplification o Introduction to diagnosis coding, official coding guidelines, and hospital inpatient procedure coding Introduction to Medicare and Patient Status o Types of Medicare coverage o Overview of observation services o Defining the hospital inpatient for Medicare fee-for-service beneficiaries (e.g., two-midnight rule, Hospital Readmission Reduction Program) Overview of Professional Services and Medicare Advantage: Hierarchical Condition Categories (HCC) o Introduction to professional reimbursement contrasting documentation requirements for hospital inpatient reimbursement and CMS-HCC payment methodology The Outpatient Prospective Payment System (OPPS) o Introduction to OPPS payment methodology o Medicare inpatient-only procedures o Comprehensive Ambulatory Payment Classification (APC) groups Tuesday, June 9 Inpatient Prospective Payment System (IPPS) and MS-DRGs o Overview of the Medicare IPPS system o Overview of MS-DRGs and MS-DRG assignment principal diagnosis, complications/comorbidities (CCs) and major CCs, principal procedure, and the impact of principal diagnosis on medical necessity denials Reviewing the Medical Record o Whose documentation can be used for code assignment o An introduction to querying o The CDI and coding perspective of medical record review, traditional role of CDI, and utilization review perspective on record review Improper Payments and Compliance Hospital Payment Monitoring Program (HPMP) o An introduction to the Medicare Administrative Contractor (MAC) o An introduction to the Quality Improvement Organizations (QIO) o Introduction to the role of the Recovery Auditor o Office of Inspector General (OIG) Annual Work Plans Wednesday, June 10 Identifying Organizational Vulnerabilities and Opportunities o An introduction to Comprehensive Error Rate Testing (CERT) o The Program for Evaluating Payment Patterns Electronic Report (PEPPER) 4

5 Introduction to Quality o A history of CMS quality initiatives overview of basic quality concepts, including adverse events and never events, and quality initiatives affected by the inpatient population o The different types/categories of quality metrics and their significance Hospital Inpatient Quality Reporting (IQR) o History and evolution of hospital IQR o The potential impacts of IQR on reimbursement and organizational reputation o The role of principal diagnosis assignment in IQR Hospital-Acquired Conditions (HAC) and Present on Admission (POA) Status o Introduction to the traditional HAC program o The significance of the POA indicator on CMS quality metrics CMS and OIG studies on POA accuracy The new Hospital Acquired Conditions Reduction Program (HACRP) Introduction to complication of care codes as defined by coding guidelines Thursday, June 11 Hospital Value-Based Purchasing (HVBP) o An introduction to HVBP o Coded data elements that can impact the reporting of HVBP o The impact of the principal diagnosis on HVBP PSI 90: The Composite Patient Safety Indicators (PSI) o An introduction to PSIs o The potential impact of PSI 90 on CMS quality programs o The elements of PSI 90 Hospital-Acquired Infections (HAI) o An introduction to HAIs o Nosocomial infections o HAIs that are and are not HACs o Surveillance data vs. coded data o HAIs currently used in CMS quality metrics CLABSI, CAUTI, SSI, VAP *Course agenda subject to change. CONTINUING EDUCATION UNITS AAPC This program has prior approval of the AAPC for 28 Continuing Education Units. Granting of this approval in no way constitutes endorsement by the AAPC of the program, content or the program sponsor. American Health Information Management Association (AHIMA) This program has been approved for 28 CE credits for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Association of Clinical Documentation Improvement Specialists (ACDIS) This program has been approved for 30 continuing education units towards fulfilling the requirements of the Certified Clinical Documentation Specialist (CCDS) certification, offered as a service of the Association of Clinical Documentation Improvement Specialists (ACDIS). 5

6 American Nurses Credentialing Center (ANCC) HCPro is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. This educational activity for 30 nursing contact hours is provided by HCPro. California Board of Registered Nursing HCPro is approved by the California Board of Registered Nursing to provide 36 nursing contact hours. California BRN Provider #CEP Commission for Case Manager Certification (CCMC) This program is approved by the Commission for Case Manager Certification for 28 Continuing Education Units. Continuing Medical Education This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of The Greeley Company, Inc. and HCPro. The Greeley Company, Inc. is accredited by the ACCME to provide continuing medical education for physicians. The Greeley Company, Inc. designates this educational activity for a maximum of 30 AMA PRA Category 1 Credits TM. Physicians should only claim credit commensurate with the extent of their participation in the activity. Disclosure Statement: HCPro has confirmed that none of the faculty/presenters, planners, or contributors have any relevant financial relationships to disclose related to the content of this educational activity. 6

7 PROGRAM REGISTRATION HCPro Advancing CDI Boot Camp June 8-11, 2015 Co-hosted by Register online at Organization: Contact Telephone: Contact Person: Contact REGISTRANTS: Name Title Phone PROGRAM FEES (per registrant): MCHC Members $ 1,495 Non-Members $ 1,545 TOTAL AMOUNT DUE: $ PAYMENT OPTIONS: PAY BY CREDIT CARD Fax completed registration form to Helena Lefkow at ( ) VISA ( ) MasterCard ( ) Discover ( ) AMEX Acct. no.: Exp. Date (mm/yy): Name on card: Signature: PAY BY CHECK Please follow the instructions below to submit your check to MCHC. Please allow at least 7 days for mailing and processing. Your space will not be confirmed until the check is received by MCHC. 1. Select the Pay by Check option and or fax the completed registration form to [email protected] or Make check payable to MCHC-Service Corp. and include the attendee name(s) and program number in the memo line. 3. Mail the check AND a copy of registration form to: MCHC Service Corporation PO Box Chicago, IL REGISTRATION AND PAYMENT MUST BE RECEIVED BY FRIDAY, APRIL 10, 2015.