Event Type: Webinar
HIM Domain: Data Quality and Data Content Standards
Continuing Education Units Available: 2
The Agency Financial Report (AFR) for FY 2015 Medicare and Medicaid accounted for 99% of the improper payment of which was $88 billion of the $89.9 billion. Of that number $43.3 billion was Medicare fee-for-service, and $29.1 billion was from Medicaid.
The webinar explains how CMS ‘s Program Integrity reduces fraud waste and abuse and can save taxpayers billions of dollars annually by using medical necessity, overpayment and eligibility verification. By using key accurate sources, indicators on claims, and other data points, analytics will be the driver of finding potential risk that can cause an audit or investigation.
At the end, attendees will have a clear understanding of how to identify program integrity issues as it relates to their business and will be able to make informed business decisions that will lead to actionable results to remain in compliance.
Attendees will be able to:
Attendees will be able to:
Identify CMS’s Program Integrity sources as it relates to audits.
Articulate other Program Integrity identifiers used in audits
Examine the basic analytic concepts and apply appropriate methods and tools used in Program Integrity Audits
Analyze RAC issues and applying fees for analysis
Attendees will be able to identify risks in their Program Integrity with data analytics. By using data analytics, they will help improve business decisions while demonstrating a commitment to program integrity. They will be able to identify services that are medically necessary, correctly coded and that their respective associated payment amounts are correct for the appropriate services rendered. The information provided will better prepare them for an audit or review.
By being a steward of good data, an understanding of Program Integrity will help all attendees reduce waste, identify fraud and abuse in healthcare.
1. Introduction to Program Integrity
2. Introduction to the importance of Healthcare Analytics
3. RAC issue examples using analytics
4. Analyzing Claim data using analytics
5. Choosing the appropriate analytic tool
Case study 1
Case study 2
Case study 3
Non member Rate
Non Member: $119
Onsite Registration Not Available
Video or audio recording of any portion of this event is strictly prohibited.
To receive a refund, notice is required at least five
days prior to the program. With proper notice, fees are refunded minus a
$40 service fee. No refunds are given for cancellations received with less than five days notice. AHIMA reserves the right to cancel or
reschedule a webinar due to unforeseen circumstances.
All Web Replay, CD, and MP3
(MP3s available with select programs)
sales are nonrefundable.
AHIMA provides full refunds, less a processing fee of $125, for registration cancellations made up until 61 days prior to the date of the first day of the program. A partial refund of 75 percent is provided for registration cancellations made between 60 and 46 days prior to the date of the first day of the program. NO REFUNDS are provided within 45 days of the date of the first day of the program. All refunds are processed within 30 days of receipt.
Substitutions (that is, assigning a paid registration to another individual) must be requested at least 31 days prior to the date of the first day of the program. A processing fee of $75 will be invoiced at that time. Substitutions are not accepted within 30 days of the program date and no refund will be given.
Rescheduling (that is, postponing the use of a paid registration to a future instance of the same program) is subject to availability and limited to future instances of the same program currently advertised on ahima.org and occurring within six months of the original program date and within the same year. Requests received at least 46 days prior to the first day of the program will be considered. Approved changes will be assessed a processing fee of $125. Rescheduling is not permitted within 45 days of the program date; no refund will be provided. Registration must be utilized during the same year of purchase.
SUBMITTING REQUESTS FOR REFUNDS, SUBSTITUTIONS AND RESCHEDULING
AHIMA reserves the right to modify, cancel or reschedule any event or meeting due to unforeseen circumstances. Registered attendees will be notified of cancellation in advance of program with options of one of the following: (1) re-register for any rescheduled program if available or (2) receive full refund of monies paid for the cancelled program. Cancelled Program Refunds: Refunds for registration fees paid for cancelled programs with no rescheduled options will be paid in full and automatically sent to attendees with 30 days of notification. Rescheduled Program Refunds – Registrants for rescheduled programs will receive notification instructing registrants about either re-registering for the rescheduled program or obtaining full refund. AHIMA assumes no responsibility for personal expenses. Requests for refunds, substitutions, and rescheduling must be submitted in writing to the Meeting Registrar by fax to (312)233-1500. All requests should include the name and date of the program. For substitutions, please include both the original registrant and the substitute registrant’s: name, mailing address, phone number, e-mail address, and order reference number. Notification of approval will be made within seven days of receipt of the request.
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This is an online event. No hotel needed.
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This is an online event.