Understanding Provider-Based Rules (PBRs) can be tough, and changes in physician supervision and reimbursement rules add to the complexity. Provider-based operations face unique coding and billing challenges – such as how to establish the Emergency Department (ED) portion of the chargemaster to capture all charges, how to line items in the chargemaster for non-emergency care in the ED, and whether ED and clinic modifiers should be in the chargemaster. And if you’re not sure where to begin, you’re not alone.
Attend this audio conference by industry veteran Duane C. Abbey, and get clear about all these issues – and also learn how to correctly implement all your PBR-specific coding and billing requirements. Abbey will review the Provider-Based Rules, help you understand the key differences between freestanding and provider-based clinics, and explain the economic advantages of provider-based clinics. He will walk you through the compliance issues associated with provider-based status, and also explain the benefits of provider-based clinical services within the hospital.
You will understand ED services and their impact on the chargemaster, learn how the chargemaster should be established to support coding and billing for technical and professional components in ED and provider-based clinics. Abbey will also teach you how to: set fees, conduct patient relations, organize your medical staff effectively, and organize multiple provider-based clinics. He will walk you through Section 603 of the 2015 Bipartisan Budget Act (BiBA) and the 21st Century Cures Act – both of which significantly affect provider-based clinics – and will work through several case studies involving the establishment of the chargemaster for both ED and provider-based clinics.
After attending this audio conference, you will be able to implement all PBR-specific coding and billing requirements, and have the tools and the knowledge to ensure that your clinic is paid appropriately.
You will learn the following:
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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