HEALTHCARE HORIZON RHC WORKSHOP OUTLINE

RHC Basics and Regulations

• Should you be a RHC?
• Advantages/Disavantages
• RHC or FQHC?
• Types of Ownership & Advantages
• Profit Benchmarks
• HPSA Waiver Options
• Non-Rural Waiver Options
• NP/PA/CNM Regs
• Management & Billing Software Facts
• New Final BBA Regs (if available)
• Medical Records Requirements
• SOAP Documentation
• MSP & Patient Check-In
• New Revenue Codes
• NPI Issues

REIMBURSEMENT/BILLING

• Charge for What You Do
• Difference Billing and Charges
• E & M Coding Essentials
• Billing for Procedures
• Discounts and Sliding Scales
• Part B Billing
• APC / Hospital-based Billing
• Diagnostic Test Billing
• Labs
• Global in the RHC
• OB/GYN in the RHC
• Nursing Home Billing
• The “Four Walls Concept”
• Maximize Reimbursements

“Understanding the RHC Cost Report

• Three Sections of the CR
• RHC Legal Structure - Important to Your Rate
• Non-RHC Costs Impact Your Rate
• Reclassifications & Adjustments
• Productivity Standards vs Reality
• Reasonable Provider/Owner Salary
• Salary Allocation and Documentation
• How to Read the CR
• Allowable and non-Allowable Costs
• Medicare Bad Debt Reimbursement
• Flu & Pneumonia Reimbursement
• The Three Parts of the CR Settlement
• Importance of a Working Trial Balance
• Critical Access Hospital CR Differences
• Hospital-Based Rate Differences
• Hospital-Based CR Differences

Certification and Inspection

• The Pol-Pro Manual
• State Inspection Issues
• Annual Evaluation Outline
• What Happens When The Annual Evaluation is no Longer Required?
• QAPI: What is Expected
• Facility Issues
• Supervision of the NP/PA/CNM
• New Requirements From Inspectors
• Logs Required
• CLIA  & HIPAA Issues

ADMINISTRATION & MANAGEMENT

• Medical Director Requirements
• Rental of RHC Space
• Self-Referral Concerns
• Use of Contracted Providers
• Collecting Co-Pay Up Front
• Use of a Billing Agency vs “doing it yourself”
• Scope of Practice
• MediCAID: Participant Discussion
• Sliding Scale Fee:  Does it help?
• National Health Service Corp Site?
• Recruitment & Retention

THIS INFORMATION WILL BE TAUGHT ON DAY TWO OF THE TWO-DAY WORKSHOPS.  JIM ESTES, PRESIDENT OF HEALTHCARE HORIZON IS THE INSTRUCTOR.  THIS OUTLINE WILL ALSO BE THE CONTENT OF THE ONE-DAY INTENSIVE RHC WORKSHOPS AS SCHEDULED.

EACH PARTICIPANT WILL RECEIVE THE PRINTED WORKSHOP MANUAL, AND - - NEW THIS YEAR - - A CD IN MICROSOFT WORD FORMAT THAT CONTAINS THE WORKSHOP MANUAL AND LOTS OF RHC HELPS, FORMS, CMS MEMORANDUM AND MORE!

SEATING AT ALL WORKSHOPS IS VERY LIMITED!  REGISTER TODAY!