Operationalizing Information Governance: Beyond the Definition

Information is an organization’s most valuable strategic asset. Every decision that is made at a health care organization, from patient care decisions to hiring decisions to the supplies to be ordered to acquisitions, are based on information. A health care organization cannot assume that its information is accurate and meaningful. Information must be managed in a thoughtful, standardized and holistic way, and it must be managed across the entire organization. This webinar will review the complexity of the lifecycle of information and the challenges that can cause an organization to go “off course,” creating risks, increasing costs, and affecting all business decisions, including patient care.

This presentation will reinforce the importance of information governance (IG) for health care organizations and will take the discussion beyond the definition of IG by providing examples of how HIM professionals can demonstrate the need for IG by showing operational significance across the entire organization. The lifecycle of information will be the focal point for discussions around the operational challenges and return on investment for IG practices. Participants will leave with tools and resources for building an IG program using information management practices, and will gain:

  1. An understanding of IG, what it is and why it’s important;
  2. Insight into the complex components of the lifecycle of information, including the challenges health care organizations face;
  3. An understanding of how IG concepts can be used to address these challenges; and
  4. Checklists that can be used to assess its areas of risk and actionable items.

Speaker: Ann Meehan, RHIA

The Next Generation in Quality Improvement: eCQMs

The days of manually reporting quality measures are over. Knowing how to use electronic clinical quality measures (eCQMs) and interpret what they tell about organizational and provider performance is essential. This session will review eCQMs, the quality data model, value sets, and more. Several widely used eCQMs will be deconstructed and discussed in detail for a more in-depth
understanding.

By the end of this webinar, attendees will:

  1. Define an eCQM;
  2. Understand the components and related standards;
  3. Explore the data quality model; and
  4. Explain the requirements for eCQM implementation.

Speaker: Susan Fenton, PhD, RHIA, CPHI, FAHIMA

New Paradigm: Managing and Preventing Denials in a Clinically-Driven Revenue Cycle

Technological advances and imperatives for greater efficiency are driving the health care revenue cycle evolution. With the continual advancement of technology, providers need to look to restructure their process and tools to succeed. Clearly defining the procedure with a solution will help in leveraging what is happening across the health care continuum – in particular the areas where clinical care is provided and clinical activities seamlessly generate charges.

Denials prevention is currently the biggest challenge within clinically-driven revenue cycle management and can be prevented using a holistic revenue cycle approach with a denials management program. This presentation will review the components needed for a successful denials management program, including: charge capture, defending payor audits, denials prevention, denials committee/tasks force, and tracking and trending success.

Attendees will be empowered to:

  • Understand the fundamental differences between a back-end versus a clinically-driven revenue cycle denials management program;
  • Learn the steps needed to implement a successful denials management program in the changing revenue cycle paradigm; and
  • Discover what tools and resources are necessary to effectively appeal denials, manage payor audits, and reduce/prevent denials.

Speaker: John Hataway

Managing RAC Responses in the Physician Practice

The California Department of Health Care Services (DHCS) and the Centers for Medicare and Medcaid Services (CMS) has contracted with Health Management Systems, Inc. (HMS) to act as the Recovoery Audit Contractor (RAC) for California. According to the DHCS website, “HMS’s mission is to help protect the integrity of government sponsored health and human services programs.” As a RAC, HMS works to identify, audit, and recover improper Medcaid payments for Fee-for-Service and managed care populations. HIM professionals are challenged with navigating and managing this complex environment.

This webinar will provide attendees with clarification on:

  • Who is HMS
  • Does HMS conduct Medi-Cal or Medicare audits
  • Are the notifications paper or electronic
  • Subrogation demands when Medi-Cal is secondary payer
  • What if the patient’s coverage is Medicare/Medi-Cal
  • Are the Additional Documentation Required (ADR) letters for hospital or private practice records

Who Should Attend:

Revenue Cycle Directors and Managers, HIM Directors and Managers, CDI Directors and Managers, CDI Specialists and Leaders, and CFOs. Professionals in inpatient and outpatient settings.

Speaker: Diane Brooks, RHIT, CCS-P

Spring 2020 SCHIMA Midlands/Upstate Region Webinar Series

Thursday, April 23, 2020
10:00 AM – 1:00 PM ET

Conflict Resolution
Eston Rodgers, RHIA

Living in a Price Transparent World
Kyle Sherseth, CHFP

Do you Know your Patient’s Social Determinants?
Tiffany Ortiz, RHIT, CCS, CCS-P

Friday, April 24, 2020
11:00 AM – 1:00 PM ET

The Value of a Complete Quality Auditing Program
Angela J. Knight

SCHIMA Coding Roundtable
Nancy Lindberg, RHIT, CCS