Payers have a relentless pursuit of profit margin; meanwhile, most hospitals continue to operate in the red. Medicare Advantage and so-called “frictionless healthcare” are adding to the confusing ways payers behave, muddying the waters and masking denials. So, what can providers do about it? This workshop will present strategies that will help you get your house in order, hold accountabilities, enforce your rights, and escalate payer issues – all with the goal of changing payer behavior. Learn more about payer behaviors today evolving payer behaviors that are on the horizon.
The UM & CDI Continuum from the ED to the QIO – Part 1
HCC’s: What’s the 411 for the Inpatient CDS & Coder
Join us for an overview of CMS HCC risk adjustment fundamentals for the inpatient clinical documentation specialist and coder. We will review the top ten commonly under-reported diagnoses that map to a CMS HCC, review how risk scores are calculated, impact payment, and benefit from improved clinical documentation and comprehensive coding.
The Coronavirus Public Health Emergency (PHE) is coming to an end. What happens now?
What happens to the...
Nuances Around the 2-Midnight Rule
Have you ever wondered...
On-Demand: Nuances Around the 2-Midnight Rule
Part 1Part 2Have you...
On-Demand: Medicare Advantage Organizations and the Games They Play
Physician Advisors sit at the intersection of clinical decisions, regulatory requirements, managed care contracts and reimbursement. Impacting operational and financial performance requires analytics and tools beyond managing the observation and denial rates. This workshop will help you understand the right analytics to measure to comprehensively assess and impact operational and Medicare Advantage Organization performance.
Savvy Sequencing Using the “Two or More” Guideline
You’re confident your team is doing it all it can to ensure appropriate reimbursement. You perform CDI reviews, diligently review mismatches, perform coding quality assurance reviews, and utilize prebill DRG optimization applications, but are you certain that your team uncovered all the revenue optimization opportunities? Join this session to learn more, ask questions, and engage with Angela Carmichael.
There is More to CMI than You Think
Date: Wednesday, May 25, 2022
Time: 10:00 am PST | 12:00 pm CST
Duration: 70 minutes
CMI Benchmarking + CMI Acuity Adjusted Variance, Now What? How To Attack The Gap
Case Mix Index (CMI) is...