Overview
Maintaining a sound utilization review (UR) process remains critical in the face of inpatient and outpatient hospital admissions changes due to COVID-19 and the public health emergency. Changes to billing and coding guidelines, as well as a decline in elective procedures, have upended hospital revenue projections. But with a clear understanding of the latest patient status regulations and a robust UR program in place, facilities can work toward ensuring no money is left on the table.
Sign your team up to watch the Mastering Utilization Review and Patient Status: A NAHRI Virtual Event on-demand to learn the latest strategies for concurrent and retrospective UR, Part A to B rebilling, inpatient-only list management, and prior authorization so you can protect your bottom line.
Participating in the Mastering Utilization Review and Patient Status: A NAHRI Virtual Event will allow you to earn valuable CEUs and will provide you with access to all educational sessions for 60 days.
Who should attend?
- Utilization review, utilization management team members
- Physician advisors
- Revenue integrity specialists and analysts
- Revenue integrity managers, directors, and VPs
- Revenue cycle managers, directors, and VPs
- CFOs
- Finance directors
- Business office staff
- Reimbursement managers and directors
- Case management directors, managers, and staff
- Chargemaster coordinators
- HIM managers and directors
- Coding managers and directors
- Compliance officers
- Compliance managers
- Patient financial services managers
- Patient financial services staff
- Payer relations staff
- Managed care contracting staff
After attending this event, attendees will be able to:
- Discuss details of CMS’ new rules for procedures formerly on the inpatient-only list
- Review coverage of outpatient and observation services and how they are counted toward the 2-midnight benchmark
- Define observation status and the intricacies of observation billing to ensure compliance
- Review the prior authorization program, including newly approved procedures and the rules and processes
- Discover how to use the utilization management (UM) committee to go beyond the basic requirements to create greater healthcare value for your hospital
- Identify ways physician advisors can strengthen revenue integrity while contributing to quality and documentation improvement
- Describe key elements of support physician advisors need to deliver value
- Identify ways clinical documentation integrity can support UR functions
- Understand when and why self-denials can be more effective than using condition code 44