Ensuring Your Organization is RAC Ready: High-Cost, High-Reimbursement Cases.
Track
:
Compliance/Legislative/Legal
Program Code:
C02
Date:
Tuesday
,
June
16,
2009
Time:
10:15 AM to 11:30 AM
EST
Location:
Room 620, WSCTC
CO-SPEAKER
(S):
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about each speaker.
Lynn Leoce, MSN, RN, CPUR, IQCI, ACM, Corporate Director Case Management, Adventist Health System
Lynn Leoce is the Corporate Director of Case Management for Adventist Health System and has served in this capacity since March of 2004. Her case management experience includes manager of case management, complex case management and total health care management for Florida Hospital Orlando. In addition, Lynn served as a member of the Optimum Stay Committee, Ethics Committee, and Palliative Care Committee. Prior to case management, Lynn served as an assistant nurse manager for family practice, womens health, renal transplant unit, and perinatal high risk unit at Florida Hospital Orlando.
Thomas McCarter, MD, FACP, Chief Clinical Officer, Executive Health Resources Dr. McCarter is Chief Clinical Officer of Executive Health Resources (EHR), a national organization that provides technology-enabled, expert Physician Advisor teams concentrating on managing Medicare and Medicaid regulatory compliance, minimizing inappropriate medical necessity denials and achieving appropriate lengths of stay in acute care hospitals and health systems. At present, EHR works with more than 500 hospital and healthcare organizations in 44 states, has an exclusive endorsement of the American Hospital Association and has received the elite Peer Reviewed designation from the Healthcare Financial Management Association.
SPEAKER
:
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about each speaker.
Robert Corrato, MD, MBA, President & CEO, Executive Health Resources
Dr. Corrato founded EHR in 1997 and has since served as EHRs President and Chief Executive Officer. At present, more than 1700 hospital and healthcare organizations across the country are using EHRs solutions. Since the start of the Recovery Audit Contractor (RAC) demonstration project, Dr. Corrato has amassed extensive experience with all stages of the RAC review and appeal process. He has engaged in thousands of RAC denial appeals and hundreds of Administrative Law Judge hearings, and has achieved unmatched success in obtaining the reversal of admissions inappropriately denied by RACs.
Prior to founding EHR, Dr. Corrato held the post of deputy director of the Office of Health Policy and Clinical Outcomes at Thomas Jefferson University in Philadelphia. An internist with extensive outpatient, inpatient, academic and community-based clinical practice experience, he is one of only six physicians in the U.S. to have completed medical fellowship training in managed care/administrative medicine. Dr. Corrato earned his master of business administration degree from the Wharton School of Business at the University of Pennsylvania and received his medical degree from the Medical College of Pennsylvania.
Learning Objectives:
Analyze areas most likely to expose your facility to risk with regard to accurate, consistent patient status classification for targeted procedures
Design methods for mitigating risk and implementing proactive measures to avoid audits and medical necessity denials
Develop an understanding of the financial and compliance implications associated with clinical mis-classification or inconsistent procedures