Deconstructing Compliance for Physician Supervision in Provider-Based Clinics


Webinar Details

Speaker

Toni Elhoms

Industry

Healthcare

Speciality

Coding/Billing

Available

All Days

Duration

60 Minutes


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.

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

Registration Options

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Toni Elhoms
Toni Elhoms

(CCS, CPC, CPMA, CRC)

Toni Elhoms, CCS, CPC, CPMA, CRC, AHIMA-Approved ICD10-CM/PCS Trainer is an internationally known speaker and recognized subject matter expert on medical coding, reimbursement, and revenue cycle management. She is the Founder and CEO of Alpha Coding Experts, LLC. She holds multiple credentials with the American Health Information Management Association (AHIMA) and the American Academy of Professional Coders (AAPC). 

With over a decade of industry experience, she has led and supported hospital systems, universities, physician practices, payers, law firms, government agencies, and other entities on coding, billing, and compliance initiatives. She is a frequent contributor to various media outlets, speaker, and regular guest on industry podcasts. She created the Alpha Coding Podcast series to share her industry Pro-Tips. She also leads and mentors a network of revenue cycle management professionals across the country and serves as the President of the Orlando, FL AAPC Chapter.