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Deconstructing Compliance for Physician Supervision in Provider-Based Clinics

Presented by Toni Elhoms
Duration - 60 Minutes

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Recorded Webinar - $229 $109
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Description

Provider-based billing models can be tedious and confusing, requiring competent oversight and training to ensure compliance with these stringent Medicare rules. Physician supervision requirements vary depending on the type of services being provided as well as the location of the service. In today’s webinar, we will discuss the physician supervision requirements for diagnostic services and therapeutic services, the rules for on-campus vs. off-campus departments as well as the different types of physician supervision – general, direct, and personal required for each setting.

Speaker

<p><strong>Toni Elhoms, CCS, CPC, CPMA, CRC, AHIMA-Approved ICD-10-CM/PCS Trainer </strong>is an internationally known speaker and recognized subject matter expert on medical coding, reimbursement, compliance, and revenue cycle management. She is the Founder and CEO of Alpha Coding Experts, LLC (ACE). She holds multiple credentials with the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). Toni's expertise extends to both inpatient and outpatient coding, compliance, billing, and reimbursement. She serves as ACE’s Senior Consultant and conducts training and educational seminars across the country. With well over a decade of industry experience, Ms. Elhoms has led and supported hospital systems, universities, physician practices, payers, law firms, government agencies, and other entities on coding, billing, and compliance initiatives.</p> <p>Toni is a frequent contributor to various media outlets, a highly sought-after conference speaker, and a regular guest on industry podcasts. She frequently serves as an expert and consulting witness in both civil and criminal litigation matters. Ms. Elhoms was appointed as an editorial advisory board (EAB) member for The Coding Institute (TCI) in 2020. She created and regularly hosts the Alpha Coding Podcast series (rated a top industry podcast) to share her industry Pro-Tips. She is a regular volunteer and mentors a network of Revenue Cycle Management (RCM) and Health Information Management (HIM) professionals across the United States.</p>

Toni Elhoms, CCS, CPC, CPMA, CRC, AHIMA-Approved ICD-10-CM/PCS Trainer is an internationally known speaker and recognized subject matter expert on medical coding, reimbursement, compliance, and revenue cycle management. She is the Founder and CEO of Alpha Coding Experts, LLC (ACE). She holds multiple credentials with the American Health Information Management... Read more

Learning Objectives

  • Understand different types of physician supervision requirements for provider-based billing
  • Recall physician supervision requirements for diagnostic services in provider-based billing
  • Recognize physician supervision requirements for therapeutic services in provider-based billing
  • Recall physician supervision requirements for on-campus and off-campus hospital departments in provider-based billing
  • Recognize common scenarios for each setting type in provider-based billing

Areas Covered

  • Outline different types of physician supervision requirements for provider-based billing
  • Discuss physician supervision requirements for diagnostic services in provider-based billing
  • Discuss physician supervision requirements for therapeutic services in provider-based billing
  • Identify physician supervision requirements for on-campus hospital departments in provider-based billing
  • Identify physician supervision requirements for off-campus hospital departments in provider-based billing
  • Review common scenarios for each setting type in provider-based billing

Background

Hospital outpatient billing in a provider-based setting can be very nuanced and complicated.  In provider-based billing – the main provider is the hospital, which in turn is responsible for ownership and operation of another location to provide additional healthcare services. These hospital outpatient clinics are subject to stricter government regulations because the patients are essentially being treated by the hospital either on-campus or off-campus. Provider-based billing requires qualified and competent revenue cycle management to ensure that providers are correctly identified and eligible for provider-based status and are also appropriately reimbursed.

Why Should You Attend

Medicare rules for provider-based billing compliance are quite complex to navigate. There are very specific physician oversight and supervision requirements for diagnostic services and therapeutic services, many nuances for on-campus vs. off-campus supervision requirements, etc.

Who Should Attend

  • Coders
  • Auditors
  • Billers
  • Educators
  • Consultants
  • Health Information Management Professionals
  • Revenue Cycle Management Professionals
  • Revenue Integrity
  • Medical Providers of all specialties
  • Physician Advisers
  • Compliance Officers/Committees