EMTALA: How it applies to Coding and Billing in the Emergency Department

Event Information
Product Format
Prerecorded Event
90 minutes
Product Description

EMTALA Compliance and How it Applies to the Emergency Department


If you are coding and billing for the emergency department (ED), you might have faced these questions:

  • Are there special coding and billing requirements for the ED?
  • How should ED documentation be developed?
  • Why is EMTALA such a difficult area? What are hospitals really required to do under EMTALA?
  • What really constitutes hospital property?
  • What is a prudent layperson?
  • What about non-emergency presentations to the ED?
  • How do ER services interface to observation services?
  • What constitutes an ED? Are there freestanding EDs?
  • Why are transfers from one hospital ED to another hospital such a sensitive issue?
  • Do ambulance services have anything to do with EMTALA?

Join expert speaker Duane C. Abbey, Ph.D., in this 90-minute session to find the answers, and also get advice on EMTALA and issues associated with coding, billing and reimbursement for the ED particularly under the Medicare program.

Session Objectives:

  • Find out why coding, billing and reimbursement are different for the ED?
  • Insights on special documentation requirements for the ED
  • Why it’s imperative to develop a special ED compliance plan
  • Learn about the current and evolving requirements for EMTALA compliance
  • Understand the definitions and conditions for EMTALA and how these concepts apply to coding and billing
  • Compare and contrast EMTALA with the Conditions for Participation (CoPs)
  • Comprehend the special coding and billing requirements for the ED relative to EMTALA
  • Understand the provider-based clinic interface to EMTALA
  • Insights on special issues such as freestanding EDs
  • Review different approaches to audits and reviews of the ED relative to coding, billing and EMTALA

Session Agenda: 

  • Overview of ED Compliance
    • EMTALA Compliance
    • Coding, Billing and Reimbursement Compliance
    • Special ED Considerations
    • ED Documentation
    • Observation and Associated Services
    • Special Payment Processes
  • EMTALA Basics
    • Definitions
    • On-Going EMTALA Rule Changes
  • EMTALA Compliance
    • EMTALA Survey Process
    • EMTALA Compliance Problem Areas
  • Evolution in EMTALA Rules & Regulations
    • Special Services Hospital Transfers
    • Community Call Programs
    • Qualified Medical Persons
    • State Operations Manual - Interpretive Guidelines
  • Coding, Billing and Reimbursement for the ED
    • Special Coding and Billing Requirements for the ED
    • Coding and Billing Policy and Procedure Development
    • Non-Physician Providers (NPPs) in the ED
    • Joint Services Between Physicians and NPPs
    • EMTALA Interface to Coding/Billing
  • Special ED Situations
    • Provider-Based Clinics – EMTALA Requirements
    • Hospital Clinics Deemed as Dedicated EDs
    • Written Compliance Plan Relative to EMTALA
    • Freestanding EDs
  • Audit and Review Approaches
  • References for Further Information

Who should attend:

ED Directors and Managers, ED Personnel, ER Physicians, ER Nurses, Coding Personnel, Billing and Claims Transaction Personnel, Chargemaster Coordinators, Financial Analysts, Compliance Personnel, and Other Interested Personnel

Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.

Order Below or Call 1-844-384-4744 Today

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About Our Speaker

Duane Abbey Hospital Coding & Compliance Expert

 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....   More Info
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