PMG is proud to offer a comprehensive list of WebEx presentations for early 2010. We have designed these presentations specifically for the CHC market — they are not retrofitted, edited versions of sessions for the for-profit healthcare arena.
Our WebEx presentations provide an in-depth understanding of the subject matter with plenty of time for questions and answers. The facilitator, Ray Jorgensen, CPC, has presented to state and regional primary care associations, the National Association of Community Health Centers and countless CHCs. Ray covers each topic in a creative and lively manner, includes relevant outside sources with applicable footnotes and injects humor to keep attendees from dozing.
Each session login is $79. Attendees who register for four or more sessions receive a 10% discount.
Each session begins at 11 a.m. ET and runs for 90 minutes.
- Front Desk & the Revenue Cycle: Feb. 9
- CHC Coding 2010: Part I, Feb. 12; Part II, Feb. 26; Part III, March 5
- Nurse Practitioners — Billable or Expendable in the CHC World?: March 16
- Charge Setting & Costing: May 11
- Key Performance Indicators: May 13
- CHC Coding 2010: Part I, June 14
- CHC Coding 2010: Part II, June 21
- CHC Coding 2010: Part III, June 28
- CEO — Top 10 Questions for Billing: June 15
Please send an email or call Robert at 1-888-330-8884 x 108 with questions
WORKSHOP DESCRIPTIONS
CHC Financial Performance Indicators
Level: Introductory to Intermediate
Track: Financial Management
Target Audience: Administrators, Board Members, Financial Professionals, Clinicians
Is your CHC fiscally healthy? What financial indicators are meaningful to you and why?
Do you understand the value of negative net A/R? What are acceptable performance
levels, and/or reasonable benchmarks for your billing department/service? Attend this
session and learn what is possible. Elevate expectations, enhance process, and watch
performance soar. Bill for and collect all the money you are owed more efficiently and
completely.
Upon completing this session, the participants will be able to:
- Explain what core performance indicators determine fiscal health.
- Describe why correct code capture better justifies cost based reimbursement via appropriately elevated charges.
- Determine how to interact with financial professionals with little to no health care
experience to better explain payments vs. adjustments and why contractual
adjustments are desirable.
Duration: 1.5 Hours
Presenter(s): Ray Jorgensen, MS, CPC, CHBME; Partner, PMG Inc.
Charge Setting and Sliding Fee Scale Considerations
Level: Introductory to Intermediate
Track: Financial Management
Target Audience: Administrators, Board Members, Financial Professionals, Clinicians
Do you charge enough for the services you provide? Do you simultaneously assure
access to cash paying patients not qualifying for sliding charges? How do you know
what to charge? What objective methodology do you utilize to determine your charge
schedule? You update it every year, right? Attend this program to learn the most optimal
means by which you can set charges, meet the needs of the under and uninsured while
assuring optimal revenue capture from all payers. Expanding Medicare Advantage and
managed Medicaid practically necessitate expertise in this key financial arena.
Upon completing this session, the participants will be able to:
- Better understand the Resource Based Relative Value Scale (RBRVS).
- Utilize RVUs and/or the Medicare fee schedule for calculating charges.
- Describe nuances and potential pitfalls of utilizing professional courtesy and
financial hardship waivers, as well as “prompt pay” discounts.
Duration: 1.5 Hours
Presenter(s): Ray Jorgensen, MS, CPC, CHBME; Partner, PMG Inc.
Optimizing the Billing Process: Expectations & Benchmarks
Level: Introductory to Intermediate
Track: Financial Management
Target Audience: Administrators, Board Members, Financial Professionals, Clinicians
What does it cost you to get paid? What is your blended encounter rate? How many
billing FTEs (full time equivalents) really work on your billing process and what should
your total expense be as a percentage of payments? Most CHCs are overstaffed at
nearly twice the necessary level. Are your days of accounts receivable (DAR) less than
50 days and if not, why not? Attend this program to learn what is possible… don’t ask
your colleagues because most are performing at sub-standard levels and have accepted
this as the norm. Learn how to go from good to great performance.
Upon completing this session, the participants will be able to:
- Analyze key billing process performance indicators and learn how many billing
FTEs you should be budgeting.
- Describe the key components of the billing process and best practices for
improving performance.
- Describe aspects of the billing process that are controlled by the billing staff
versus elsewhere in the organization.
Duration: 1.5 Hours
Presenter(s): Ray Jorgensen, MS, CPC, CHBME; Partner, PMG Inc.
The Encounter Rate- Understand What is Included and What
is Excluded
Level: Introductory to Intermediate
Track: Financial Management
Target Audience: Administrators, Board Members, Financial Professionals, Clinicians
What is an encounter rate? How is it calculated? Can you define “core provider” status?
When are you paid for a medical and a mental health service for the same patient on
the same date of service? How are non-core provider visits reimbursed? How does it
vary by payer? Attend this session to learn these answers and remove the mystery
around NGS/UGS and Medicaid cost based payments. Learn what additional payments
are available based on “wrap arounds” or “carve outs” not bundled into cost based
reimbursements. Learn why Medicare Advantage and managed Medicaid programs could
be financially damaging to you.
Upon completing this session, the participants will be able to:
- Explain how encounter rates are calculated and why the blended encounter rate
is perhaps the most critical financial data element to be shared with staff.
- Describe when to bill NGS/UGS as well as your local Part B carrier for services on
the same date of service.
- Describe minimum documentation requirements for a medical and mental health
service for the same patient on the same date of service.
Duration: 1.5 Hours
Presenter(s): Ray Jorgensen, MS, CPC, CHBME; Partner, PMG Inc.
Non-Physician Practitioners (NP, PA, & CNM)- Understand if
They are Billable or Expendable
Level: Introductory to Intermediate
Track: Financial Management
Target Audience: Administrators, Board Members, Financial Professionals, Clinicians
Is your organization unclear regarding coding, billing, and being paid for services
rendered by Non-Physician Practitioners (NPP; i.e., nurse practitioners, physician
assistants, and/or certified nurse mid-wives? How are they compensated under cost
based/encounter rate reimbursement? When may you bill for NPP rendered services
under a doctor? How do you bill plans who do not recognize or credential a NPP? What
are the “incident to” billing rules and when do they apply? Attend this program to learn
these answers and how to critically think about NPP provider utilization to optimize
reimbursement.
Upon completing this session, the participants will be able to:
- Explain “incident to” billing criteria, the basic “litmus test” for billing under
another provider, as well as the varying compensation levels of MD/DO vs. NPP
providers.
- Describe how clinical oversight guidelines/statutes differ from billing
requirements (i.e., an appropriately rendered clinical service may not be
legitimately billable).
- Describe Federal “shared visit” (MD/DO with NPP on same date of service) policy
and its potential impact.
Duration: 1.5 Hours
Presenter(s): Ray Jorgensen, MS, CPC, CHBME; Partner, PMG Inc.
Optimal ICD Coding.
Level: Introductory
Track: Clinical
Target Audience: Finance Directors, clinicians and billing staff
Take this crash course in ICD coding to understand the pragmatic application of ICD
coding to clearly convey medical necessity as well as the appropriate mix of chronic
versus acute, symptomatic versus screening, etc. Focused on providers taking charge of
this important process learn of industry tools and AHA coding guidelines which demystify
this vexing process. Providers and billers together learn why theirs must be a symbiotic
versus combative relationship.
Upon completing this session, the participants will be able to:
- Understand History of ICD coding & need for specificity in code selection.
- Explain the logic and necessity of ranking and linking ICD codes.
- Understand V Codes and reason for visit coding.
Duration: 1.5 Hours
Presenter(s): Ray Jorgensen, MS, CPC, CHBME; Partner, PMG Inc.
CEO… Top 10 Questions.
Level: Introductory to Intermediate
Track: Administrative and Finance
Target Audience: Board of Directors, CEO, Executive Directors and Finance Directors
Too burdened with BOD, grant requests, and senior management hiring issues to learn
whether you are leading a fiscal champion or drain? In one session, learn the key
questions to ask and benchmarks to which staff should perform. Become suddenly
insightful and knowledgeable in an arena most non-financial C level staff dread.
Upon completing this session, the participants will be able to:
- Understand key financial and billing criteria
- Understand billing benchmarks and why they are important.
- Analyze revenue cycle reports and how the organization measures itself.
Duration: 1.5 Hours
Presenter(s): Ray Jorgensen, MS, CPC, CHBME; Partner, PMG Inc.
3rd Party Payer Negotiations.
Level: Introductory to Intermediate
Track: Administrative and Finance
Target Audience: Board of Directors, CEO, Executive Directors and Finance Directors
Third party payer contracts too vexing to engage? Not certain what you can ask for or
when? Suffering along with fees and contractual commitments negotiated years before
you were hired? Learn what and when to negotiate with payers as well as common
pitfalls and discriminatory practices targeting non-profit health care providers who
manage large Medicaid populations. In one session, gain a wealth of potentially
optimizing negotiation options.
Upon completing this session, the participants will be able to:
- Understand basic third party contracts and language contained therein
- Locate danger areas and other “What to Watch for” items.
- Discuss various negotiation options and methods
Duration: 1.5 Hours
Presenter(s): Ray Jorgensen, MS, CPC, CHBME; Partner, PMG Inc.
Understanding E & M Coding
Level: Introductory to Intermediate
Track: Clinical
Target Audience: Finance Directors, clinicians and billing staff
Participants in this session will finally understand the most common code set in the
entire CPT book. Evaluation and Management (E&M) coding is used by CHC providers
daily and yet is not well understood. As important is the relation to reimbursement
especially when managed care organizations are increasing market share. Why is
medical necessity important? Is there a direct relationship between the E & M and
diagnosis code? Attend this session to clear away any ambiguity from the coding
process, understand documentation guidelines and make coding decisions with
confidence.
Upon completing this session, the participants will be able to:
- Understand the most common E & M codes and levels
- Recognize the strengths and weaknesses of documenting time
- Understand out-patient and in-patient coding algorithms
Duration: 4.5 Hours
Presenter(s): Ray Jorgensen, MS, CPC, CHBME; Partner, PMG Inc.
You are the (E & M Coding) Auditor
Level: Introductory to Intermediate
Track: Clinical
Target Audience: Finance Directors, clinicians and billing staff
The E & M Code Auditing course will finally answer your documentation questions. Was this visit
a level 3 or 4? Is this really a consult or just a visit? What need to be in the record to ensure the
code chosen is substantiated? Understanding what an auditor is looking for will enable the
provider to finally have confidence in their E & M documentation. Providers and billers together
learn why coding and documentation are important to the organization.
Upon completing this session, the participants will be able to:
- Understand basic documentation principles and requirements
- Describe the differences between new and established patient visits.
- Understand when to use the Modifier 25 correctly
Duration: 4 Hours
Presenter(s): Ray Jorgensen, MS, CPC, CHBME; Partner, PMG Inc.
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