Provider-Based Clinics: Ensuring Compliance

MessageThis Webinar is over
Date Jun 28, 2017
Time 12:00 PM EDT
Cost $198.00
Description :
Healing facilities are always progressively setting up provider-based clinics of numerous types.The provider-based regulation (PBR) is difficult and there are unmistakable uncertainties.Even though hospitals can benefit from high revenues from provider-based clinics, adherence to every rules and regulation is demanding.A Recent modification in the supervisory prerequisites for provider-based operations has caused misunderstanding and new compliance tasks. Moreover, there are currently new charging prerequisites for off-campus provider-based facilities.
In the course of this seminar, the general objectives and roles of the provider- based regulation is discussed and also the essential facts about doctor supervisory modifications and new charging plan.Furthermore, the general compliance problem encompassing provider-based status will likewise be debated with regards to carrying out an audit.
Objectives of the session :
  • To survey the Provider-Based Rule (PBR).
  • To survey the conditions that must be completedbeforehospitalscan be seen as provider-based.
  • To survey charging and guarantees to document changes for provider-based operations.
  • To keep the basic physician supervisory regulation changes up to date.
  • To examine documentation prerequisites with respect to doctor supervision necessities.
  • To value the diverse aspects in which the PBR applies.
  • To comprehend the verification and demand for assurance processes.
  • To comprehend the requirement for updating and the documentation of organizationalarrangements in respect to the PBR.
  • To comprehend the survey procedure for evaluating current and/ orprobableprovider-based conditions.
  • To comprehend the effect of Section 603 Bipartisan Budget Act of 2015 alongside the effect of the 21st Century Cures Act.
  • To comprehend the financial benefits versus the compliance prerequisites.
  • To value the relationship of PBR with respect to the Conditions for Payment, Conditions of Participation and picking up charging benefits.
  • To work through a few contextual investigations.
Agenda of the session :
1.Study the Provider-Based Rule (PBR) 
  • Advancement of the PBR 
  • 42 CFR §413.65 
  • Assessment of Definitions 
  • Standards and Regulations 
  • Acknowledgment by Non-Medicare Third-Party Payers 
2.Economic benefits of Provider-Based Status 
  • Facilities 
  • Clinical Services 
  • Price of Provider-Based Status 
3.Provider-Based conditions
  • Owned, Operated and Fully Integrated 
  • Geographic Proximity 
  • Signage and Recognition 
  • Clinical Integration 
  • EMTALA Interface 
  • Notice of Two Copayments 
  • Part Billing 
1.    Utilization of PO Modifier 
2.    Utilization of appropriate Place of Service 
  • Shared Space Distress
4.Doctor Supervisory Requirements 
  • Current Modifications and Clarifications 
  • In-Hospital 
  • On-Campus 
  • Off-Campus 
  • Conceivable Recovery Audit Contractor (RAC) Problems
5.Compliance and Responsibilities Under PBR 
  • Satisfy All PBR Criteria 
  • Report Requirements
  • Verification versus Determination Process 
6.Provider-Based Audits 
  • In The Hospital 
  • On-Campus 
  • Off-Campus 
8.Information Gathering and Evaluation
  • Survey of Provider-Based Operations 
  • Appraisal of Requirements and Prohibitions 
9.Active Steps 
10.Current Legislative Initiatives 
  • Section 603 BiBA 2015 
  • 21st Century Cures Act Section 16001 
11.Advanced Problems
  • Shared-Space 
  • Holding-Out to the Public 
  • Administrative Contracts 
  • Under Arrangements 
12.Related Issues 
  • Conditions for Payment 
  • Prerequisites for Participation 
  • Other Third-Party Payer Relations 
  • Coding and Billing for Provider-Based Clinics 
13.Case Studies – Provider-Based Clinics 
Who should attend ?
  • All personnel involved with provider-based clinic and/or clinical operations
  • Compliance personnel
  • Coding and billing personnel
  • Nursing staff and interested physicians are encouraged to attend.


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