With the new year fast approaching, it is imperative that hospitals are ready for the various changes that are being proposed and going into effect with the updated Joint Commission National Patient Safety Goals.
In this session, our expert will cover all of the Joint Commission National Patient Safety Goals (NPSGs) for hospitals as well as resources available to help hospitals comply with the National Patient Safety goals. Additionally, our expert will be going over all of the specific changes that were made over the past few years, including medication reconciliation standards, CMS revised blood transfusion, and more.
After this webinar participants will be able to:
|- Elimination of transfusion errors||- CMS revised blood transfusion standards|
|- Medication reconciliation standards||- Universal Protocol changes to prevent wrong site surgery|
|- Proposed changes in 2019||And so much more!|
Anyone who is involved in implementing and following the Joint Commission National Patient Safety Goals (NPSGs), including but not limited to: Joint Commission Coordinator, Quality Improvement staff, chief nursing officer (CNO), patient safety officer, nurse educator, all nurses with direct patient care, pharmacist, pharmacy staff, infection preventionist, nurse manager, chief medical officer (CMO), nursing supervisor, nurse manager, nursing director, policy and procedure team, compliance officer, risk manager, hospital legal counsel, and medication team members.
The world of healthcare is changing rapidly and so is the role of case management in that world! Federal fiscal year 2019 promises to bring new and exciting changes that will impact your work as a case management professional. Whether you are reading or hearing about value-based reimbursement, the Affordable Care Act, the continuum of care, bundled payments, transitions in care, or accountable care organizations, case management is at the center of it all!
Because things are changing so rapidly it can be a challenge to stay current and knowledgeable in the issues that most greatly impact your role as a case manager. Each year we bring you the latest and greatest in the field of acute care case management. We hope to do the same for you again this year! Reimbursement has changed dramatically as has utilization management, transitional planning and compliance. CMS has incorporated changes that impact on payments related to readmissions, length of stay and the cost of care. Who is in a better place to address these issues than case managers! Finally, how do you measure your impact on the cost and quality of care and the reimbursement your organization receives for that care?
All these topics and more will be covered in this jam-packed five-part series. The program will start with an overview of the state of the art in case management today, how we got here, and where we are going in the future including a review of acute care reimbursement. From there we will discuss the often-confusing subject of all the roles that occur in best practice departments. You will learn more about the complimentary, but separate roles of RN case managers and social work case managers. From there, we will address best practice case management department models. We will then review what utilization management and transitional planning really mean under the current CMS rules and the new CMS proposed rules. We will end our series with a discussion on the best ways to measure the outcomes of your case management department and its impact on the organization.
Whether you are new to case management or a seasoned pro, this webinar series will provide you with the latest and most up-to-date topics and information that you will need to be at the top of your game and produce the best outcomes for you, your patients and your organization.
Part I (January 29th): A Review and Preview of Acute Care Case Management and Reimbursement Strategies for 2019 (90 Min each)(1 PM EST)
|- Healthcare industry today||- Mandate for change||- Medicare|
|- Medicaid||- Managed care definition||- Managed care contracting|
|- Managed care products||- The history of case management||- The evolution of case management|
|- Acute care case management||- Community based case management||And more!|
Part II (Feb 12th): Acute Care Case Management Roles, Models and Staffing Ratios: Who Does What and When? (90 Mins each)(1 PM EST)
|- Standards of case management practice||- Definitions of case management||- Statement of philosophy|
|- Guiding principles||- Patient flow||- Utilization and resource management|
|- Denial management||- Variance Tracking||- Transitional and discharge planning|
|- Integrating case management roles||- Skill sets||- The case management process|
|- Case management models||- Pros and cons of different models||And more!|
Part III (Feb 27th): Utilization Management: What Does it Really Mean? And Where Should it Reside? (90 Mins each)(1 PM EST)
|- Utilization management definition||- Medical necessity defined||- Compliance components of medical necessity|
|- Billing and reimbursement||- Best practice in clinical reviews||- Managing utilization from the bedside|
|- Appropriate UM documentation||- Proactive denial management||And more!|
Part IV (March 12th): Discharge And Transitional Planning Under The Current and Proposed CMS Rules (90 Min each)(1 PM EST)
|- Transitional planning as a process||- Case management transitions||- Admission assessments|
|- Social work triggers||- Home care triggers||- Influences on transitional planning|
|- Discharge planning compliance||- Next level of care providers||- Hand-off communication|
|- Transitions time-outs||- How to hard-wire your processes||And more!|
Part V (March 27th): Measuring The Success Of Your Case Management Department: Do You Make the Grade? (90 Mins each)(1 PM EST)
|- Define outcomes||- Quality outcomes||- Cost outcomes|
|- Case management outcome levels||- Departmental goals||- Productivity measures|
|- Where do you find benchmarks?||- Managing avoidable delays||And so much more!|
After this webinar participants will be able to:
Anyone involved with or interested in case management, including but not limited to: CEOs, CFOs, COOs, CMOs, CNOs, CE Directors, Department Directors, Quality Improvement Staff, Physicians, Nurses (all levels), Compliance Officers, CMS Liaisons, TJC Liaisons, Registration Staff, Safety Officers and Staff, Pharmacy Staff, Ethics Committee Members, Consumer Advocates, Risk Managers, Legal Counsel, Behavioral Health Staff, Psychiatry Staff, Social Workers, Discharge Planners, Case Managers, Hospice Staff and Regulatory Affairs Staff.
If you’re wondering about the new Targeted Probe and Educate (TPE) Audits, you’re not alone. By and large, hospice staff don’t understand the new TPE audits, nor do they know how to navigate through these payment scrutinies. This can lead to payment denials, and seriously impact your reimbursement in 2019.
Learn how the new TPE process works and what auditors will likely be looking for in 2019 in this informative session by hospice compliance guru Jnon Griffin. Gain a solid understanding of the data analysis used to select hospices for TPE audits and of how the TPE process works. Discover what these audits are looking for, so you’ll have a better chance to ensure your documentation is up-to-par.
After attending this audio conference, you’ll walk away with a firm grasp on how the new TPE process works and how to effectively document and analyze data so you can potentially avoid these audits. You’ll get firsthand feedback on the TPE audits and process, with a special emphasis on real-world strategies for quality, compliance, and billing issues.
This how-to session will cover:
Who Should Attend
This program is designed for hospice educators, QAPI/PI, executives, compliance staff, billers, nurses, and leadership
Podiatry is a provider specialty in which the coding and reimbursement rely heavily on services performed in the office setting, therefore Podiatry practices need to make sure they know the current coding updates for 2019 that will affect them, as well as implement these changes in a timely manner.
Podiatrists have strict policies, dictated by the State in which they practice, and understanding the scope of practice in their state, and applying rules and guidelines to make sure they are not only submitting correct claims, but they are reporting everything they can for reimbursement, and what is considered inappropriate to bill.
In 2019, there are new diagnoses codes for myalgia and Medicare’s final rule for E&M services will bring a possible major change for podiatrists. Don’t forget the new biopsy and allograft codes for 2019 and revised documentation guidelines for DMEs.
Attend this webinar by expert speaker, Lynn M. Anderanin to get a detailed view and insights on the coding updates in podiatry that will impact your practice in 2019. Get the right information that will result in correct coding and billing for clean submissions of claims. Also, learn about the latest updates and changes for podiatry that are already in effect or will come into effect from January 1, 2019.
Handout: You will receive a PPT with useful information and web resources for ready reference later.
Note: This is an ideal training session for any member of a Podiatry practice involved in the coding utilizing CPT®, HCPCS and ICD-10-CM. If your job involves assisting and determining what should be billed, and work with patients on their insurance eligibility and coverage, you shouldn’t be missing this webinar.
Who Will Benefit:
This seminar will review the regulatory requirements for investigating an OOS Investigation. The responsibilities of the analyst, the supervisor and QA will be discussed. A detailed flow chart will be used to help the attendees clearly understand the steps and the order in which they are to be performed. The structure of an Investigation report which properly documents the investigation will be discussed.
The lack of or Inadequate procedures for handling out of specification (OOS) situations and failure investigations are amongst the most frequently found deviations in FDA warning letters. Most companies have procedures but either they are not adequate or are not followed. This seminar will guide attendees through the entire process from detection an out-of-specification result to informal and formal laboratory and batch investigations.
Areas Covered in the Session :
Guidelines for Detecting an OOS or Atypical Result
Testing the hypotheses regarding potential root causes
Developing a proper CAPA plan to address any Corrective Actions
Who Should Attend:
Being in compliance with HIPAA involves not only ensuring you provide the appropriate patient rights and controls on your uses and disclosures of protected health information, but you also have the proper policies and procedures in place. If audited or the subject of a compliance review you will be required to show the government you have all the necessary documentation in place for safeguarding patient Protected Health Information and indicate how you addressed all required privacy safeguards.
Why You Should Attend:
With a substantial increase HIPAA data breaches and increased government enforcement, organizations must understand patient’s rights for access to their health records under the HIPAA Privacy Rule. Attendees will leave the course clearly understanding of all the requirements that must be in place for meeting this rule for the protection of personal health information their organizations maintain, create, transmit, or store. After completing this course, a healthcare provider will have a clear understanding for what needs to be place when it comes to meeting these HIPAA requirements for medical records.
Areas Covered in the Session :
Who Should Attend:
The webinar will focus on identification of a breach and what the required process is to remedy a breach if it is determined one has occurred, The initial overview of HIPAA requirements and policies will help the attendee determine if his or her practice is compliant.
The collection of laws and regulations known commonly as HIPAA is comprised of two federal statutes and three federal rules:
The Health Insurance Portability and Accountability Act of 1996 ("HIPAA"),the Health Information Technology for Economic and Clinical Health Act of 2009 ("HITECH"), the Privacy Rule (found at 45 C.F.R. 164.500 et. seq.), the Security Rule (found at 45 C.F.R. 164.300 et. seq.) and the Breach Notification Rule (found at 45 C.F.R. 164.400 et. seq.).
The three rules were amended and combined in 2013 into what is known as the HIPAA Privacy, Security, Enforcement and Breach Notification: Final Omnibus Rule. The federal Office for Civil Rights ("OCR") has the duty and responsibility to investigate complaints or reports of potential HIPAA violations and to continuously monitor entities required to comply with HIPAA ("Covered Entities") for compliance. OCR began a preliminary pilot program for random compliance audits of Covered Entities in 2015.
The OCR looks at several areas of HIPAA compliance when performing an audit including:
All medical practices must have a designated Security Officer who is responsible for HIPAA security. The designated Security Officer should perform regular internal Compliance Risk Assessments as well as staff training sessions to ensure that all of the proper protections are in place and are functioning properly.
OCR is on schedule to begin its second round of HIPAA audits in early 2016 and plans to include many more types of Covered Entities than were included in the first phase as well as Business Associates (as defined by HIPAA) of Covered Entities.
One of the essential items that OCR will be looking for is the proper performance of an internal Compliance Risk Assessment and the implementation of any necessary plans to cure any problems that are discovered as a result of the Compliance Risk Assessment.
Although OCR will not be publicly posting any audit results, the results are not confidential and the potential financial consequences of a poor audit are substantial. Any Covered Entity or Business Associate who has not yet performed an internal Compliance Risk Assessment should plan to do so immediately and should begin to prioritize the necessary changes which result based upon the level of risk involved in each deficiency.
Why should you Attend: HIPAA compliance is one of the most cited and least understood laws in the typical medical practice. Although HIPAA has been in place for decades, it has changed rapidly in the last ten years due to the rapid proliferation of technology in medicine.
In addition to these progressive changes, the law itself underwent a major overhaul in 2013 resulting in any practice that has not updated their HIPAA materials since that time being out of compliance. The speaker will highlight the major changes that must have been implemented after the 2013 HIPAA updates. Thereafter, the attendee will learn the basic requirements for a Notice of Privacy Practices as well as when authorizations are and are not required for the use and disclosure of a patient's protected health information.
The latter half of the webinar will focus on identification of a breach and what the required process is to remedy a breach if it is determined one has occurred.
The federal Office for Civil Rights, the government entity tasked with enforcing HIPAA began a preliminary pilot program in 2015 to ensure a certain number of random compliance audits of Covered Entities.
The initial overview of HIPAA requirements and policies will help the attendee determine if his or her practice is compliant. Thereafter, the speaker will highlight what "red flags" the Office for Civil Rights looks for when determining whether to audit a practice and learn what to do in the event you are selected for a random audit.
Areas Covered in the Session:
Who Will Benefit:
Do you understand the latest government audit and contractor trends? This webinar will provide insight into Unified Program Integrity Contractors (UPICs) and how they relate to Zone Program Integrity Contractors (ZPICs) and Medicaid Integrity Contractors (MICs). These trends include the "2 in 1" audits initiated by UPICs and recent tactics, including serial record requests, probe audits, "secret" patient interviews, and auto-denied claims. Learn how to prepare for and recognize these trends during an audit. From the 10 questions every staff person should know, to testing your organization's record production capabilities, this program will empower you to prepare for and defend against government audits.
Who Should Attend?
This informative session will benefit hospice CEOs, COOs, officers, and compliance managers and directors.
CMS has finalized some significant changes to the hospital conditions of participation (CoPs) that every hospital should know, including critical access hospitals. It was 393 pages long and combined three laws into one. This includes changes to nursing, medical records, infection control, QAPI, patient rights, H&Ps, and restraint and seclusion.
Most have an effective date of November 29, 2019, with two exceptions. The normal implementation date is 60 days but Critical Access Hospitals will have 6 months to implement an antibiotic stewardship program and 18 months to implement a QAPI program since their QAPI requirements were completely written.
It will also require all hospitals to have an antibiotic stewardship program and what the program should include. Also, a great part of this document included things that CMS has found to be problematic in hospitals that are already a requirement in the hospital CoPs. CMS also clarified a number of existing requirements and a number of federal regulations that are already final which makes this webinar an excellent resource.
Patient Rights and Medical Records
Nursing Services and Outpatient Departments
Look Back Program and the Lab
Four swing bed changes
Infection Control and Antibiotic Stewardship
Who Should Attend?
Case Management Boot Camp (Part 3 of 5) - Emergency Department (ED) Case Management: A Must-Have for any Hospital Case Management Department
Case management models in the acute care setting are constantly evolving and improving. So is true for case management in the emergency department. RN and Social Work case managers working in this fast-paced setting must evaluate patients who will be treated and released, those being placed into observation and those being admitted to an inpatient bed. Therefore, it is imperative that the ED case management model is consistent with the inpatient model yet applied differently in order to address these categories of patients.
During this program, our speaker will discuss the structure of a best-practice ED case management model and the processes the roles should follow. She will also discuss the outcome measures for ensuring that your ED program is making a difference for your organization.
At the conclusion of these sessions, participants will be able to:
Anyone involved with transitions in care including RN case managers, case management personnel, social work staff, post-acute care providers, physician advisors, finance directors, quality management and other interested personnel.