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Reporting Quality in Rural & Community Health:A Focus on Clinical Documentation & E/M Bootcamp
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Reporting Quality in Rural & Community Health:A Focus on Clinical Documentation & E/M Bootcamp

 Export to Your Calendar 9/30/2019 to 10/2/2019
When: Sept. 30 - Oct. 2, 2019
Day 1: 8:30am - 4:30pm Day 2: 8:30am - 4:30 Day 3 8:30am - 12:30
Where: West Baton Rouge Convention & Visitors Bureau Plantation
North Westport Dr. Room 2750
Port Allen, Louisiana  70767
United States
Contact: Julia Scott
4049376633

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Louisiana Reporting Quality in Rural & Community Health:A Focus on Clinical Documentation &

Evaluation & Management Bootcamp

 

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Day 1 - Reporting Quality in Community Health: A Focus on Clinical Documentation September 30, 2019

 

General description

This live and online course is designed for providers, quality managers, ACO leadership, and revenue cycle staff at community health facilities who need a high-level basic explanation of how to report accurate quality metrics and who deal with HEDIS, HCC, QIP, Risk Adjustment, and Share Savings.

 

After a brief overview of HEDIS/HCC and other Quality Improvement Programs, we will dive into relevant sections of the ICD-10-CM's "Official Guidelines for Coding & Reimbursement" and will review the instructional notes associated with key diagnoses in order to most accurately report the true complexity of care for your ACO patients and to:

 

·      recognize the impact of medical documentation on the accuracy and completeness of quality data,

·      report accurate and complete Quality Metrics via historical claims data,

·      how to fully report the true complexity of your patients via ICD-10-CM documentation rules.

 

General Objectives

 

1 - Attendees will be able to unify their clinical documentation goals with the requirements of ACO's to adjust payments based on clinical complexity of its patient population.

 

2 - Attendees will learn about the specific documentation guidelines and base code instructional notes associated with the major disease categories being tracked by ACOs.

 

3 - Attendees will learn a structure by which they can train their providers on those additional codes and HCC categories that may become a focus in the future and how their EHRs may hinder effective training.

 

The following groups will benefit from class:

 

·       Providers who create clinical documentation (e.g. MD/DO/PA/NP) and have primary responsibility for capturing documentation necessary to support .

 

·       Nurse/Quality Managers who manage people and policies related to voluntary or contractually-required reporting of data via CPT, HCPCS-II, and ICD-10-CM codes and who serve as a link between the clinical and business staff.

 

·       Coders/billers who have do not have experience in measuring and reporting key quality metrics via UDS, HEDIS, HCC, and internal ACO requirements related to educating providers on proper code usage.

 

 

Basic Agenda (times can be adjusted)

·       8:30 am - 9 am

    • (optional) Course registration and attendee takes pre-test (10 questions to be compared to results in post-test)
  • 9 am - 12:00 pm
    • Orientation to course materials and coding manuals
    • Roles and staffing responsibilities for quality reporting
    • Basics of HEDIS, HCC, ACO Shared Savings, and Risk Adjusted Coding
    • Where can diagnoses be pulled from in an encounter note?
    • Overview of CPT Category II codes and ways to increase revenue
  • 10:30 am - 10:45 am – BREAK
  • 12:00 pm – 1:00pm – LUNCH
  • 1:00 pm - 3:00 pm
    • Deep review of the ICD-10-CM Official Guidelines for Coding & Reporting
    • Balancing clinical care and quality reporting requirements
  • 3:00 pm - 3:15 pm – BREAK
    • Quick break and move chairs into small groups
  • 3:15 pm - 4pm
    • Hands-on individual and group exercises

 

Day 2-3 Evaluation & Management Bootcamp -  October 1-2, 2019

 

Objectives:

This interactive 2-day training is intended for healthcare practitioners, medical billers, coders, auditors, office managers and IT professionals involved with authoring clinical documentation, generating E&M progress notes, auditing professional physician service claims and maintaining a healthy revenue cycle. The primary course focus will emphasis documentation guidelines set forth by CMS for reporting Evaluation and Management services (E&M), as defined by CPT. The curriculum will provide attendees with a strong grasp of Evaluation and Management auditing, coding and documentation techniques.

 

The curriculum is designed to assist in development and mastery of the necessary skill set to successfully audit Evaluation and Management (E&M) services. This education and training has been designed to promote compliance and minimize the risk mitigation associated with post-payment review and 3rd party audit exposure.

 

Curriculum specifics will include:

The “Key Components” associated with E&M code selection

The differences between the CPT and CMS E&M documentation guidelines

Discuss the use of utilization benchmarks to target potential risk areas

Explain the differences between the 1995 and 1997 examination guidelines

Determining the complexity of medical decision making (MDM)

The importance to ‘link’ ICD-10-CM codes to E&M services

Risks associated with certain EHRs solutions (e.g, “wizards”)

Distinguishing “problem-oriented” from “preventive” E&M services

What to look for when modifiers are reported with E&M services (e.g., -25)

How to use a well-constructed audit template to conduct reviews

Key steps to present audit findings to providers successfully and non-confrontationally

 

Day 1 of the program primarily focuses on instruction and review of pertinent source documents (e.g., AMA’s 2019 CPT guidelines and CMS’ E&M Documentation Guidelines and some of the categories of E&M services located in CPT.

 

Day 2 of the program will be used to reinforce Day 1 learning objectives while focusing on specific categories of E&M service. There will be a series of hands-on cases for instructor-led audit instruction followed by individual or small group audits of cases presented by class attendees.

 

IMPORTANT! - For added value - bring your own notes for solo or small group review so you walk out with completed audits! Please be sure to remove any and all information that can identify the patient- this is known as being HIPAA de-identified.

Attendee Responsibilities:  Each attendee is expected to present to class with the following:

 

2019 CPT (AMA Professional Edition strongly encouraged)

Up to 5 HIPAA de-identified E&M cases for potential solo and/or group hands-on review

2 highlighters

A printed copy of the CMS Evaluation & Management Services Guidelines

A copy of any internal audit tools, templates, or score sheets currently being utilized by your facility

CEU– 11 CEUs approved by AAPC & ArchProCoding

CME – 11 (Continuing Medical Education) Credits for MD, DO, NP, PA, RN:

*This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the joint providership of the University of Nevada, Reno School of Medicine and Association for Rural & Community Health Professional Coding.  The University of Nevada, Reno School of Medicine is accredited by the ACCME to provide continuing medical education to physicians. The University of Nevada, Reno School of Medicine designates this live activity for a maximum of 11 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

 

 Day 1 Agenda 10:00 a.m. – 5:00 p.m.

Overview and CPT E&M Instructions

Defining time in the inpatient/outpatient settings

When to use CPT vs. CMS E&M DocumentationGuidelines

Preventive versus Problem-Oriented E&M Services

Documenting valid chief complaints

History of Present Illness and Review of Systems (HPI/ROS)

Past, Family, Social History (PFSH)

Hands-on Exercises and QA

1995 vs 1997 CMS Examination Guidelines

Geographic considerations (e.g., MAC Guidance)

Medical Decision Making and Medical Necessity

The role of EHRs and coding software in the auditing process

Time based E&M coding

 

 Day 2 Agenda 10:00 a.m. – 3:00 p.m.

Review of all remaining CPT E&M categories

Reinforcement of “key” components, modifiers, and global surgical package considerations

Overview the ArchProCoding Audit Tool

Accurate completion of the E&M Audit tool

Instructor-led cases for audit

Individual and group audit exercises

Proficiency Exam – You will have access to a optional 50 questions proficiency exam after the completion of the bootcamp. The exam will be online and you will receive a certificate of completion

Refund Policy - Refunds up to 7 days before event. Less than 7 days you will receive credit for another live or online training if available. 

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