The CMS is not always precise in providing guidance on both regulatory and sub-regulatory issues. And in some cases, the regulatory body will not answer specific questions relative to proper metrics that should be used for auditing to ensure compliance. As a result of this ambiguous guidance, hospitals, clinics, and other healthcare providers often struggle to develop policies and procedures to handle key issues relative to Medicare. This can lead to adverse audits and payment recoupments. How do you avoid this?
Learn how in this audio conference with Duane C. Abbey. Abbey will walk you through the issues where the guidance from CMS is ambiguous, tell you what you should do, and explain why you should have written policies and procedures in place (hint: they can help provide compliance protection).
Abbey will show how ambiguous guidance can impact your Medicare audits and lead to recoupment of alleged overpayments, as well as how it can shift the burden of proof to you. He will discuss the concepts of active monitoring and immediate availability; the current status of related services of the 3-day pre-admission window; the evolving interpretations under the provider-based rule; the possible audit guidelines for meeting the over 2-midnight rule; and the difference between clarifying guidance and changed guidance. He will also get you clear on what exactly the over 2-midnight rule really says, and the difference between separately charging and separately billing.
After attending this session, you will be current with the issues where the CMS guidance is ambiguous, and more confident in your ability to handle the key issues relative to Medicare. Plus, you’ll be in a better position to develop policies and implement procedures even when the guidance is not explicit.
In this session, you will learn:
After attending this session, you will be able to:
Who Should Attend
Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.
- Sue Dill Calloway
Duane C. Abbey, Ph.D. is a management consultant and president of Abbey & Abbey, Consultants, Inc., which specializes in healthcare consulting and related areas. Duane earned his graduate degrees at the University of Notre Dame and Iowa State University and has more than 20 years of experience as a consultant. He performs various types of financial analysis involving business structuring, organizational development, enrolment and other financially related concerns of organizations....
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