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DATA MINING FOR DOLLARS seminar
This seminar will cover the changes between the pilot RAC program and permanent RAC program.
Speaker
CHERYL SERVAIS, MPH, RHIA, VP, Compliance and Privacy Officer, Precyse Solutions LLC
WEDNESDAY, MAY 14, 2008 - BUENA PARK
Holiday Inn
7000 Beach Blvd., Buena Park CA 90620 (714) 511-7000 (No parking fee.)
THURSDAY, MAY 15, 2008 - BERKELEY
Double Tree Hotel
200 Marina Blvd., Berkeley CA 94710 (510 548-7920 (No parking fee.)
REGISTER by APRIL 28, 2008 & SAVE!
CHIA Members $130.00
Non Members $165.00
CHIA Students $100.00
REGISTRATION FEES AFTER APRIL 28, 2008
CHIA Members $170.00
Non Members $205.00
CHIA Students $140.00
PRE-REGISTRATION CUT-OFF
FOUR business days prior to the seminar date. (May 8 for May 14th seminar and May 9 for May 15 seminar)
Walk-in registrations are welcome on a space-available basis only. $20.00 will be added to the applicable fee
CLICK HERE FOR ONLINE REGISTRATION
Walk-in registration available on a space-available basis.
Click Here for an alternative form of registration. This pdf file may be filled out, mailed in to CHIA Executive Office at 1915 N Fine Ave Ste 104, Fresno CA 93727-1565 or you can fax in to 559.251.5836.
PROGRAM PRESENTATION
The Recovery Audit Contractor (RAC) rules are changing. This program will cover the changes between the pilot RAC program and the permanent RAC program, anticipated to be implemented in the fall of 2008. Discussion will include the expansion of the program and the impact on coding and compliance in hospitals, the intensification of quality review criteria, and also prospective payment initiatives in the ambulatory care settings. Tools will be provided to assist in understanding and managing the latest rules by CMS to improve reimbursement accuracy. Techniques for effectively managing the RAC reviews and how to avoid payment denials will be presented.
RAC – Phase II Differences between the pilot RAC and the permanent RAC
2007 Status Report Results
Managing RAC Reviews
Important Topics • Results of RAC Pilot in CA, FL, and NY
• Characteristics of the new RAC
• Timelines for Implementation
• New mechanism/organization to process Claims
• Measuring claims accuracy
• Using claims data to monitor payment errors
• Quality Review initiatives
• Expansion of federal oversight to Medicaid/MediCal programs
• The HIM department role for supplying documentation
and monitoring coding and data quality in these and other
reimbursement initiatives
• The importance of documentation
CMS Strategies
• Streamlines claims processing
• Integrated claims data bases
• Use of claims data bases to monitor accuracy and look for
fraud/abuse
• Use of databases to monitor quality
• CMS Quality initiatives and how they use coding and claims
data
MACs – Medicare Audit Contractors (Claims Processors)
HIGLAS - Healthcare Integrated General Ledger
Accounting System
CERT – Comprehensive Error Rate Testing
PEPPER – Data You can Use
PSC - Program Safeguard Contractors
POA – Present on Admission – Key to Payment for Quality?
QIO – Quality Improvement Organization
SCIP – Surgical Care Improvement Program
DOQ - Doctors Office Quality
DRA – Deficit Reduction Act/False Claims Act – Legal Strategies
MIP – Medicaid Integrity Program
PERM – Payment Error Rate Measurement
MediCaid/MediCal monitoring
• New frontier for claims monitoring
• Federal oversight
HIM Department Role
• Documentation Improvement Programs, Coding Audits, and
Coding Education
• Team-approach to analyze data and respond to changes
• Education on new government approaches
TARGET AUDIENCE
Coders and Coding Supervisors and Managers for acute care hospitals and physician offices; Health Information Management Directors and Compliance Officers; Documentation Specialists, Patient Financial Services, Billing Office staff and providers with interest in the coding and reimbursement process related to the listed topics.
SCHEDULE
7:30 a.m. Registration/Complimentary Beverages & Pastries
9:00 a.m. Program
12:00 p.m. Networking Lunch (included)
1:00 p.m. Program
3:30 p.m. Adjournment
SPEAKER
Cheryl Servais, MPH, RHIA, VP, Compliance and Privacy Officer
Ms. Servais has more than 25 years of experience in Health Information Management. In her position at Precyse Solutions, Ms. Servais’ responsibilities include planning, designing, implementing and maintaining corporate-wide compliance programs, policies and procedures, and updating them to accommodate changes in federal and other regulations.
Materials
Participants will receive comprehensive handouts.
PAYMENT POLICY
Full payment is required with your completed registration form. A copy of an approved check request is acceptable to submit with the registration form.
CONFIRMATION
Your registration confirmation will be sent to the e-mail address or the fax number that you provide.
CANCELLATION and SUBSTITUTIONS
Cancellations received up to five working days before the seminar are refundable, minus a $30 registration service charge. Cancellations received within five working days of seminar may request to have a portion of the paid registration fee applied toward a future CHIA seminar (must be used in 12 months). This request must be made in writing and the registration service charge will still apply. If you don’t cancel and don’t attend, you are responsible for full payment. Substitutions may be made; the appropriate member or nonmember fee will apply to the substitute. Please contact CHIA Executive Office to make any cancellations or substitutions.
CONTINUING EDUCATION UNITS
This program has been approved for five Continuing Education Units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). HIM Domain: External Forces. Provider approved by the California Board of Registered Nursing. Provider number 05474 for five Contact Hours. Certificates of attendance are provided for this seminar.
SPECIAL NEEDS
If you have any special needs, indicate what accommodations you require on your Registration Form.
CONFERENCE ATTIRE
Due to variations in room temperature we suggest you wear layered clothing to ensure your comfort.
SPONSOR
Sponsored by the California Health Information Association. CHIA is an affiliate of the American Health Information Management Association and has provided educational programs for its members and other allied health care professionals for over 55 years.
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