8:00am to 3:00pm

Keiser University in Tradition

TOPIC: Diving Into Data: A Guide to Accurate Reporting for Quality Measures, Regulatory and Revenue Compliance

 

WELCOME! The Premier Healthcare Business Alliance is an organization with the mission to help local businesses and organizations grow our community by uniting each other through their services.

PRESENTING SPONSOR: FIRST CITIZENS BANK

For more than 100 years, customers have trusted First Citizens Bank with their money … and their futures. They are the nations largest family owned bank, and headquartered in Raleigh, NC. In the South Florida area the bank consists of mostly commercial accounts, with nearly 80% of accounts being in the medical/healthcare industry.

CREDITS:

This conference will provide 2 individual sessions to obtain a total of 5 CEU Credits for Medical Professionals and Medical Coders, Billers, Auditors, and Compliance Officers. All other entities will obtain certificates and submit for CEUs to their organizations.

SCHEDULE:

SESSION 1: 9:00AM-11:00AM “Separating Clinical Documentation, Professional Coding, and Billing: A Workflow Analysis” Gary Lucas

FOCUS:

Our primary focus will be discussing how to separate the clinical documentation creation process from professional coding. Coding turns medical documentation into raw data (i.e. “science”) Medical billing primarily involves translating those documented codes into compliant bills that likely have widely different rules requiring creativity (i.e. “art”). We will discuss the need to involve all staff in an ongoing team-training approach that involves your clinical providers, coders/billers, EHR staff, and facility leadership.

Most people are noticing that there is no technical solution (e.g. EHRs) to:

1. ensuring that 100% of the services provided are properly documented in the medical record,

2. ensuring that we capture all codes provided (e.g. CPT/HCPCS-2/ICD-10-CM) whether they will get paid or not

3. making sure we are reporting claims using a variety of rules to maximize revenue while minimizing compliance risks.

By discussing workflow issues on how to integrate the People, Processes, and Technologies associated with these key areas – we will be able to work together to increase the patient’s awareness of what happened and why, be able to fully maintain data on what we do, to generate the maximum allowable payments from Medicare, Medicaid, managed care, and commercial insurance companies, and to be aware of how to handle external audits from.

LUNCH SESSION: 11:30AM-12:45PM “First Citizens” & “Dynix Diagostix”

SESSION 2: 1:00PM-3:00PM “Making MACRA Measurable: A Guide to Data Accuracy Requirements for New Quality and Risk Adjustment Models” Daria Bonner, CHCA, CCP, RMC

FOCUS:

Accurate data has always been important to ensure providers are paid appropriately for the services they provide, but with the transition from fee-for-service payments to new payment models under MACRA, our data needs to be more accurate and reflective of the services we provide more than ever before. The focus on quality and risk adjustment for the first time for Part B services will require more accurate data be reported up front and not just during the claims submission process for payment purposes.

In this session attendees will learn the key components of the new payment models and their focus on risk adjustment and quality and how to ensure that their practice is measuring these key components accurately to ensure that quality and payment adjustments under these models are maximized at a reasonable cost. Learn how to prepare for the transition and avoid the penalties that will be assessed if this data isn’t accurate.

 

8:00 – 8:30 Breakfast/Registration

8:30 – 9:00 Welcome Message 

9:00 – 11:00 Session 1 “Separating Clinical Documentation, Professional Coding, and Billing: A Workflow Analysis” Gary Lucas 

11:00 – 11:30 Meet the Vendors + Campus Tours

11:30 Lunch is Served

12:00 – 12:45 Guest Speakers

1:00 – 3:00 Session 2 “Making MACRA Measurable: A Guide to Data Accuracy requirements for New Quality and Risk Adjustment Models” Daria Bonner, CHCA, CCP, RMC

3:00 Close Message 

*Agenda is subject to change.

Gary Lucas

Vice President of Education Operations, ARHPC

Gary Lucas, CPC, AHIMA ICD-10 Ambassador and serves as Vice President of Education Operations and provides strategic and tactical direction for the ARHPC. Gary provides an unique perspective by having an extensive background in education & training in the healthcare industry over the last 20 years by providing over 1,300 nationwide seminars on medical records documentation for physician and outpatient-based medical centers dealing with professional coding, medical billing, Medicare compliance, and practice management in 46 states.

Since accepting his current position with the ARHPC, Gary has provided ICD-10 implementation training and eLearning administration for the ARHPC. Gary is responsible for the design and development of several revenue cycle and healthcare education related IT products and services while still providing onsite professional training and project management services to the rural health, school-based, and federally qualified health center community.

Starting in 2007, Gary spent 4 years with Booz Allen Hamilton providing IT consulting, organizational change, and training management services to federal government clients including the Centers for Disease Control and Prevention, Centers for Medicare and Medicaid Services, and the Veterans Health Administration, among others. In 2004, Gary opened Discover Compliance Resources, Inc. and provided similar consulting services to pharmaceutical companies, medical device manufacturers, health care facilities, and the Department of Defense.

Gary holds a Masters of Science in Health Informatics from the University of Illinois – Chicago and a Bachelor of Business Administration from the University of Georgia. He currently resides in Decatur/Avondale Estates, GA and has 2 sons.

Dari Bonner, CHCA, CCP, RMC

CEO, Xact Healthcare Solutions, Inc., President, Premier Healthcare Business Alliance

Dari has over 20 years of health care industry advisory consulting and project management experience. Her areas of expertise encompass both the public and the private sector, hospitals, outpatient service centers and large and small physician practices. Dari is an expert in commercial and VHA health care business process analysis, process modeling, project management, software product development, product implementation, and health care information technology.

Dari has served as project director for multiple management-consulting firms including Booz Allen Hamilton, QuadraMed, Inc. and Ingenix. She has extensive functional knowledge of the commercial and VA Business Office environment and a detailed understanding of the revenue cycle dependencies inherent in registration, insurance verification, medical coding, billing, accounts receivable, clinical documentation and workload capture and reporting and health care compliance requirements. Dari has served as Compliance Officer for a large nonprofit commercial health care system, Director of Education & Training for a large multi-specialty physician group, and Director of Auditing and Monitoring for numerous coding, billing and accounts receivable departments. Dari has also provided advisory services to more than 200 commercial and government hospital systems, ambulatory surgery centers, insurance companies and physician practices on revenue cycle and workload process enhancement and revenue recovery. Dari is a medical coding class instructor at the Corporate and Community Training Institute at Indian River State College and she is the Chief Training Officer for the Medical Management Institute where she teaches a variety of online certification preparation and CEU credit classes.

Dari obtained her CPC (Certified Professional Coder, 1996), CPC-H (Certified Professional Coder-Hospital, 1996) and CPMA (Certified Professional Medical Auditor, 2011) through the AAPC and her CCS-P (Certified Coding Specialist-Physician) from AHIMA in 1997. She served on the AAPC National Advisory Board from 1997-1999 and was honored as Networker of the Year in 1996. Dari obtained her RMC (Registered Medical Coder) certification through the Medical Management Institute in 2014.

FIRST CITIZENS BANK

For more than 100 years, customers have trusted First Citizens Bank with their money … and their futures. They are the nations largest family owned bank, and headquartered in Raleigh, NC. In the South Florida area the bank consists of mostly commercial accounts, with nearly 80% of accounts being in the medical/healthcare industry.

DYNIX DIAGNOSTIX

As a clinical laboratory, Dynix Diagnostics understands the complex issues facing healthcare providers today.

Whether you are a physician, treatment facility owner or hospital representative, Dynix Diagnostix is here to provide the scientific evidence that is needed to ensure that your patients receive the personalized care they deserve. The different modalities of testing that we offer will deliver useful information that can be used to guide an effective treatment plan, thereby ensuring the best outcomes while managing risk.

We utilize modern technology combined with clinical methodology to stay ahead of the curve with the fastest turnaround times as possible. We strive to exceed all industry standards and to continually improve patient care.

Dynix delivers quality service and efficient results utilizing modern technology combined with clinical methodology to stay ahead of the curve with the fastest turnaround times as possible.

Learn more at http://dynixdiagnostix.com

Registration is required if you are taking any of the classes. Registration is for the entire day (8am to 3pm), which includes 2 sessions, breakfast and lunch.

This program will provide 5 CEU Credits for Medical Professionals and Medical Coders, Billers, Auditors, and Compliance Officers.

Registration: $95.00 per person

Questions?

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The Premier Healthcare Business Alliance will be donating a portion of the proceeds from the conference to support a wonderful local organization.

HANDS is a 501(c)(3) organization dedicated to increasing access to health care for low income residents. HANDS grew from a few individuals trying to help people find services into a county wide network of health providers, agencies, and volunteers dedicated to increasing health care access for low income residents. HANDS has been incorporated since October 28, 2008 and has over 30 community partners including the three local hospitals, three local medical societies, SLCHD, and Florida Community Health Center (FCHC).

The HANDS Primary Care Clinic opened on October 25, 2010. HANDS offers resources to those least likely to receive regular health care — uninsured adults age 19 to 64. Rather than simply treating acute symptoms, HANDS seeks to empower patients to participate in their health management. Their goal is to educate clients on how to make good health care choices, find health resources, and recognize health problems before they become critical.

To learn more about HANDS visit their website:

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