Provider-Based Clinics: Ensuring Compliance

Date	Jun 28, 2017
Time	12:00 PM EDT
Cost	$198.00
Online

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 
7.Procedure 

• 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.