CO-PRESENTER
:
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Stacey Harper, Executive Director - Strategic Pricing, The MetroHealth System
Stacey Harper is the Executive Director of Strategic Pricing at the MetroHealth System. She spent several years in consulting and at a Big Four Accounting firm with focus on charge capture and the charge master. She is a Registered Health Information Administrator (RHIA) and Certified Professional Coder (CPC).
SPEAKER
(S):
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Mike Kovar is an Executive Director in the Healthcare Advisory Services Practice of Grant Thornton LLP. He has over 25 years of experience in the health care industry focusing in the hospital provider areas. Mike has both operations and consulting experience focusing primarily in the regulatory, billing/coding, and compliance areas. Mike has spent over 20 years with Big Four Accounting firm where he served as Lead Partner in the charge master and charge capture areas. He has lead over 300 studies in this area focusing on the impact of regulatory and insurer changes to hospital revenues. Mike presents for HFMA nationally on a number of different revenue related topics including HFMAs Charge Master and Advanced Charge master classes.
Stacey Harper, Executive Director - Strategic Pricing, The MetroHealth System
Stacey Harper is the Executive Director of Strategic Pricing at the MetroHealth System. She spent several years in consulting and at a Big Four Accounting firm with focus on charge capture and the charge master. She is a Registered Health Information Administrator (RHIA) and Certified Professional Coder (CPC).
SUBMITTER
:
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about each speaker.
Mike Kovar is an Executive Director in the Healthcare Advisory Services Practice of Grant Thornton LLP. He has over 25 years of experience in the health care industry focusing in the hospital provider areas. Mike has both operations and consulting experience focusing primarily in the regulatory, billing/coding, and compliance areas. Mike has spent over 20 years with Big Four Accounting firm where he served as Lead Partner in the charge master and charge capture areas. He has lead over 300 studies in this area focusing on the impact of regulatory and insurer changes to hospital revenues. Mike presents for HFMA nationally on a number of different revenue related topics including HFMAs Charge Master and Advanced Charge master classes.
Description
The charge master at a hospital or other health care entity are the "aorta" of the billing system. The accuracy of the charge master drives how hospitals are paid. Since most hospitals focus on making sure that their charge master is "Medicare compliant" and do not look at the charge master as it is effected by other payors billing requirements, significant additional revenues are left on the table from other payors. Also, with the proliferation of charge master software tools in hospitals, the opportunities may no longer be in the charge master itself but in how the charge master is being used by the individual clinical departments. The seminar will identify common missed opportunities from the charge master and charge capture processes and will help attendees to develop strategies to address these issues to enhance a hospital's bottom line. We will go through various case studies and examples, have attendees look at the their own charge masters during the class to see if the opportunities discussed are present at their institution, and then discuss as a group various methods to address each issue. We will address these issues in each of the major revenue producing departments at a hospital: Laboratory, Radiology, Operating Room,Emergency Room, Cardiology, and other selected departments. Each attendee will come out of this session with a significant number of revenue enhancement opportunities at their individual hospitals that they can implement quickly when they return from the session.
Learning Objectives:
Assess compliance and effectiveness of the charge master and charge-capture processes for Medicare and other third party payers
Describe the 2010 changes in Medicares OPPS, CPT, HCPCS, Category II Codes, Category III Codes, and ambulatory payment classifications (APCs), and the effect on the charge master
Determine the impact of healthcare reform on a hospitals revenue cycle and charge master
Develop strategies to employ in selected clinical departments including the emergency, laboratory, radiology, operating room, and cardiology departments to take advantage of revenue and compliance opportunities