Diaries of a Professional Fee Coding Compliance Auditor

In a textbook environment, everything comes through easy and perfect for professional fee reimbursement – but that is not the real-world experience! Over the past decade, health information professionals have seen many changes to the documentation and coding world. With the implementation of electronic medical records, there have been many compliance risks in professional fee coding and reimbursement.

This presentation will provide an in-depth look at the most common issues seen during compliance audits for professional fee reimbursement and provide helpful tips in identifying those risks and how to avoid them. Documentation issues, templates, cloned notes, modifier usage, physician’s as the coding professional, nonphysician practitioner issues (incident to/split shared guidelines), teaching physician guidelines, critical care, and more will be explored.

Speaker: Jacquelyn Craver, RHIA, CCS, CCS-P

The Value of a Complete Quality Auditing Program

June 18, 2020
12:00 PM – 1:00 PM ET

The dynamics of coding audits has shifted since ICD-10. With the shift comes changes in procedures, coding patterns and trends. Auditing offers an ideal avenue to understand and influence overall patient health, improve clinical documentation and enhance the fiscal health of a health care organization. This provides visibility and understanding of what areas need improvements and corrections.

Providers can help increase accurate reimbursement in a faster turnaround time and provide valuable education to your coders at the same time through auditing provider’s documentation in ensure accurate coding for billing. By reviewing where provider’s, can improve will provide deep insight into process improvement.

Objectives:

  • Learn how your organization can achieve financial success, quality outcomes and avoid costly penalties.
  • Discover how to build a coding audit program with the breadth and depth that fits your organization.
  • Learn to incorporate a variety of chart selection methodologies into your program that result in the most complete, well-rounded compliance program.
  • Review how documentation must support the DX listed on 1500-ICD-10 to provide greater specificity to ensure capturing appropriate codes
  • Understand that coding applied by EHR systems is not always accurate and how to ensure accuracy.

Outline

  • How can your organization achieve financial success, quality outcomes and avoid costly penalties
  • How to build an effective audit program that fits your organization
  • Chart selection
  • Review documentation to support 1500 data
  • Understanding how to ensure EHR systems are coding your correctly

 

Speaker: Angela J. Knight

Social Determinants of Health (SDOH)

November 13, 2019
12:00 PM – 1:00 PM CT

Quality healthcare is more than visiting a provider and receiving treatment for an illness. Many people can’t even get to a doctor appointment, or if they do, they may be unable to follow their treatment plans. How can providers improve health for individuals that are facing barriers to accessing the healthcare system such as poverty, lack of transportation, or lack of adequate housing? Collecting Social Determinants of Health data is a first step to identifying people who need help and working to establish programs to assist them.

At the conclusion of this webinar, attendees will:

  • Identify Social Determinants of Health (SDOH)
  • Describe the importance of capturing SDOH data
  • Understand how accurate documentation and coding contribute to accurate data capture and reporting
  • Gain strategies to engage providers and coders in the importance of SDOH and how it benefits their organizations and communities

2019 Quad-State Education Sessions Series

Aspiring, Strong and Universal (ASU) Cover Shoot Models
Bridging to our Future: 2019 CSA Report
Building Your Coding House on a Rock – A Detailed Study of the Conventions and Guidelines
CDI in the Physician Office: Strategies from the Field
Clinical Validation Workflow: Establishing a Consistent Approach
CPT Challenges for Percutaneous Coronary Interventions
Data Analytics – The Power of Coded Data
Decoding Spinal Procedures for ICD-10-PCS
Future of HIM Workforce in the Southeastern United States
Getting to Know CCHIIM
Healthcare Payment Reform and the Role of Coding and Clinical Documentation
Heart Healthy Cardiac CPT Coding
HIM Directors: Treat Your Patients as the Consumers They Are
I Am Woman, Hear Me Roar: I’m Sorry, Was that Too Loud?
Infusion, Injections, Hydrations: “Oh My!”
Leading Anytime, Anywhere: Your Leadership Edge
Project Management’s Role in Health Information Management – “A Coding Compliance Audit Case Study”
So, you think you know ProFee Coding?
The 5 Essentials for Patient Privacy Program Success
The Heart of the Matter: Complex IP and OP Cardiac Coding Tips
The Leadership Road to Peak Potential
Understanding Interventional Pulmonology: Bronchoscopy Procedures and Coding Fundamentals
Vision 2019: Your Career Connection – Part 1 and 2
Work/Life Balance: What Is It, and How in The World Can I Achieve It?

Denial Prevention: Addressing Root Causes through Data Analytics and a Team-based Culture

March 28, 2019
12:00 PM – 1:00 PM CT

At the completion of this educational activity, the learner will be able to:

  • Define data, data analysis, information and knowledge management.
  • Identify key contributors of data in various healthcare settings.
  • Clearly distinguish the difference between Reason Code, Issue and Root Cause.
  • Determine which data elements are relevant for analysis.
  • Establish an action plan based on the information obtained from data analysis (including reports and key stakeholders).

Speaker: Tracey A. Tomak, RHIA, PMP