9:00am to 3:00pm

Keiser University in Tradition

Topic:

Healthcare Coding Data & Payment Modeling: Maintaining Quality and Measuring Risk in a Regulated Payment Environment

 

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.

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: 9:30AM-11:30AM “DRG Validation and Risks” Jessica Schmor, RN, CPC, CCS, CHCAF, AHFI, CLNC

FOCUS: Are you curious about how the Inpatient Prospective Payment System and DRGs are coded and billed for inpatient hospital settings? Participants will learn about DRG’s, but also how to validate DRG’s, what a sample audit would look like, areas of high risk as it relates to assignment of DRG’s, and much, much more. Join us for an introduction to DRGs and DRG Validation that will include group working sessions of case studies and hands-on interactive sample auditing scenarios to help.

LUNCH SESSION: 11:30AM-12:30PM 

11:45PM-12:00PM “Leadership Despises A Vacuum” Richard Brown

40+ years of leadership experience as a United States Marine Corps Officer, as a manager and leader in the pharmaceutical industry, and in coaching alpine ski racers as well as baseball players have given Richard an insightful perspective into effective and inspirational leadership.

Regardless of your specific work environment, whether you are in a formal leadership position or not, you WILL face leadership challenges. The decisions you make in those instances will determine your destiny.

Richard will share with us some leadership truths and hacks to help you meet those challenges successfully in his talk:

SESSION 2: 12:30PM-2:30PM “Reducing the Risk: How CMS Quality and Risk Adjustment Programs are Making Efforts to Minimize Healthcare Risk, Increase Quality and Control Costs” Daria Bonner, CHCA, CCP, RMC

FOCUS: Risk and quality are two buzz words that we are seeing more and more frequently in the healthcare environment. The passage of the Affordable Care Act and increased regulatory efforts established by the Center for Medicare and Medicaid are paving the way for even more increased efforts to increase quality of care through coordination between various health care providers, tracking and monitoring data submitted to federal programs, and continuing focus on compliance with state and federal programs related to payment to providers for the services they perform. In order to ensure compliance with the various regulations and programs, providers must have a clear understanding of the programs themselves and the rules and regulations of each program and the responsibility of providers to maintain compliance with all programs. In this presentation, Dari will define what each of these programs entail and provide attendees with some tips and tools to make sure that your practice is compliant.

9:00am Breakfast/Registration

9:15 – 9:30 Welcome Message 

9:30 – 11:30 Session 1 “DRG Validation and Risks” Jessica Schmor, RN, CPC, CCS, CHCAF, AHFI, CLNC

11:30 – 12:30 Lunch and Guest Speaker, “Leadership Despises A Vacuum” Richard Brown

12:30 – 2:30 Session 2 “Reducing the Risk: How CMS Quality and Risk Adjustment Programs are Making Efforts to Minimize Healthcare Risk, Increase Quality and Control Costs” Daria Bonner, CHCA, CCP, RMC

2:30 Close Message 

*Agenda is subject to change.

Registration is required if you are taking any of the classes. Registration is for the entire day (9am 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

Jessica Schmor

Founder, Allegiant Experts, LLC

Jessica Schmor is an experienced clinical coder with over 17 years of experience working with facilities, health plans, providers and attorneys. She speaks the language of the medical community and has knowledge of how all parties function and insight into the incentives that drive behaviors and actions of both healthcare providers and payors.

Jessica’s honesty and integrity have led her to working with attorneys, the Department of Justice and health plans to support civil and criminal legal cases for plaintiffs and defendants. While Jessica has been most noted for her utilization review and inpatient reimbursement expertise, she has varied experience in many other healthcare areas such as home health, skilled nursing facilities, and physician reimbursement. Jessica has been qualified as a testimony expert in coding, billing and utilization review in Federal and State courts.

In 2016, Jessica founded Allegiant Experts, LLC which provides consulting experts and testifying experts to support the varying needs of clients with cases related to healthcare issues. Allegiant Experts supports providers and payers with cost containment, pricing, audit and recovery, compliance and litigation matters to ensure quality healthcare at a reasonable price. Our clients love Allegiant Experts because of the flexibility and knowledge that we bring to help review the issues and highlight the areas for concern and risk.

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.

To Be Announced

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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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