| DVD #1: Medical Records – Electronic Health Records in the RHC:
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section provides important information on the Medical Records requirements for the RHC. The second section takes those requirements & looks at them from the Electronic Health Records perspective. PLUS: detailed information on how to transition from paper to EHR in the RHC, vendor selection, pitfalls to avoid & much more! There are several important areas that make the RHC different from other clinics when looking at EHR systems. This training will prepare you for the difficult journey into the Electronic Health Records realm! You'll even have a checklist of questions to ask your potential EHR vendor.
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| Part 1: RHC Medical Records: |
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| Patient Check-In | Pain Management Forms & Policies |
| Forms Required Annually | RX Logs |
| Forms Required Once | Retention |
| What is Required Every Visit | Problem Logs |
| Update Frequency | Minor Consent |
| Medical Necessity | Encounters Defined |
| Signature Requirements | SOAP Documentation |
| Advance Beneficiary Notice | Drug Sample Logs |
| Medicare Secondary Payer Requirements | |
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| Part 2: Electronic Medical Records in the RHC |
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| Cost vs Expectations | Implementation of new system |
| Ethnicity Data Possible | Electronic Issues With Required Forms |
| Memory? Access | Scanned Documents vs. Data Base Info |
| Transition Staff | Will System Handle MSP Requirements |
| Satellite vs DSL | Electronic Chart Co-Signature for NP/PA/CNM |
| Training | Review Required Forms |
| Potential Facility Issues | Selection Preparation |
| Vendor Selection Process | Scanning Equipment |
| Reportable Fields vs Just Data | On-line vs In-House |
| RX From Sample: Reportable Field | Electronic Pt Sign-In |
| System Selection Process | Clinic's capacity for change |
| Will System Guarantee "Certification" in Writing | Practice Analysis Important |
| Type of EHR System Appropriate for RHC | Vendor Contract Issues |
| Medical Record Scanning Decision-Making | Allow for Future QAPI |
| Bridge Existing Demo Data or Input All New Data | System Security/Policies |
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| Price: $129 |
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| DVD #2: RHC Basic Billing: |
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| This DVD provides basic billing for RHC staff. |
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| How Is RHC Paid Differently | Importance of Bundling All Charges |
| Upcoding & Downcoding Pitfalls | Hospital-Based RHC Reimbursement Issues |
| CPT/HCPCS Code Issues | Hospital-Based RHC Lab Billing Issues |
| Definition of Billable Encounter | Required Labs & CPT Codes |
| RHC "Four Walls Concept" | Revenue Codes for the UB-04 |
| Flu/PPV Billing | MediCAID Reimbursement Issues |
| Billing Hospital Charges | Medicare "Contractual" Adjustments to PT Account |
| Paperwork Billing Issues | Billing Reports Important to RHC Management |
| Billing Process for RHC Services | Reports the Biller Generates for CR Preparation |
| How to Bill "Incident To" Services | The Biller & the Cost Report |
| How to Bill Non-RHC Services | Payor Class Impact |
| Services Not Covered by Medicare | Reduced Fee |
| Beneficiary Financial Responsibility | Billing vs Charges |
| Billing for Routine & Recurrent Services | Medical Necessity |
| Billing for Disease Management Clinic | B-12 Billing Options |
| Billing for Diabetes Services | Billing Dressing Changes |
| Billing For Chiropractic Care | Billing Lab Tests |
| Medicaid Billing Exceptions | SNF Issues |
| Pain Management Billing Tips | Billing for Foot Care |
| How to Bill for Family Consultations | Nursing Home Billing |
| What to do With Telephone Services | Bill Types Used |
| Four Areas the RHC Can Bill Medicare Part B | The "30-30 Rule" |
| Split Charge & Split Bill Diagnostic Tests | Free Services |
| Billing for "other" locations | Billing Injections |
| How the RHC Payment is Determined | |
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| Price: $129 |
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| DVD #3: RHC Advanced Billing: |
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This is the perfect companion training to the Basic Billing DVD, and
provides details on the often frustrating and complicated billing in the
RHC. Information pertinent to the Independent and Hospital-Based
RHC is included.
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| MediCAID Billing Challenges | Prostate Cancer Screening & PSA Billing |
| ICD-9 Coding Issues | Welcome to Medicare Exam Billing, Codes, Etc. |
| Special Billing for non-RHC Services | PT Financial Responsibility in Behavioral Health |
| Billing for Multiple Visits on Same Day | Behavioral Health Medicare Reimbursement |
| Screening Pelvic & Pap Smears | Timely Filing |
| Cardiovascular Screening | Part B Bonus Payments |
| Billing for Visiting Nurses Services | Billing "Incident to" |
| RHC Physician Services | Behavior Health Billing |
| ICD-9 Coding Issues | Mammography |
| Medicare Advantage Plan Issues | Diabetes Screening |
| Coding & Billing Injections | Billing Telehealth |
| Beneficiary Financial Responsibilities | Hospice Billing |
| Medicare Bad Debt Advanced Issues | Discounts for Cash |
| Sliding Scale Fee Schedule Issues | Suture Removal Billing |
| 72-Hour Rule & Billing in the RHC | Billing for Hospital Visits |
| Coding & Billing Minor Surgical Procedures | Global Billing & the RHC |
| Bird-Dogging Denied Claims | CAH Billing Options |
| Billing Ofc. Tracking of Encounters | |
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| Price: $129 |
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| DVD #4: Understanding the RHC Cost Report:
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After viewing this DVD you’ll know where to look for your encounter rate,
visit count, settlement amount and much more important information for
the effective management of the RHC.
- The purposes of the RHC Cost Report
- How your encounter rate is determined?
- Encounters & the CR - where do you get your data?
- The three sections of the cost report
- Adjustments (carve-outs) to the CR?
- Re-classifications on the CR?
- Non RHC Cost Report Impact
- Medicare Bad Debt on the CR?
- Flu & Pneumonia logs & the CR?
- Productivity Requirements: is this for real?
- Accrual of physician/owner salary?
- Reasonable compensation?
- Types of physician compensation agreements?
- Medical Director's compensation?
- Physician compensation allocation?
- Rent for RHC paid to RHC owner: limitations on cost?
- Sole Proprietor/Partnership vs other types of ownership?
- Importance of filing the CR in a timely manner?
- Breakdown of CR settlement?
- Settlement reality: when do you get your money from the CR?
- Rate adjustment as a result of the CR?
- Are the numbers on the cost report correct ?
- Questions you should be asked by those preparing your CR?
- Questions YOU should ask those preparing your CR?
- How the Free-standing & Provider-Based CR is different?
- Hospital-based CR issues & their impact on the RHC “bottom-line”
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| Price: $97 |
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| Comprehensive RHC Training DVD Series: |
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This three-part training is an excellent comprehensive training for new employees, managers, & for employee evaluations. The pre-post test provides clinic administration with the information needed to increase employee awareness of clinic procedures & regulations.
This is a three-part DVD set. All three sessions include information not on the individual billing or Cost Report sessions offered by Healthcare Horizons.
This series includes regulations, inspection issues & other detailed
management information critical to the successful operation of the RHC. You receive three DVDs, each accompanied by a CD with the
workshop manual, pre-post test, appendix items & the workbook, ready for you to print & use as you view the training.
| Price: $299 |
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Session 1: Management Appropriate for Ofc. Mgr, Admin. & Accounting Staff (150 min.)
- RHC Start-Up/Conversion Issues
- RHC Management Software: Importance & Requirements
- Clinic certification & re-certification Inspection Issues
- Policy & Procedure Manual: An Outline for Your Clinic
- Medical Records: Required Forms
- Medicare Secondary Payer Questionnaire: Required! How Often?
- HPSA/MUA Criteria & Waivers
- Office Management: The Unique Problems of the RHC
- Types of Clinic Ownership & the Impact of Each Type on Profit
- Benchmarks for a Profit: Should You Be a RHC?
- New RHC legislation/regulations
- HIPAA & the RHC
- Role of the Medical Director, NP/PA/CNM Rules
- What Do We Do If Our NP/PA/CNM Resigns?
- Annual Evaluation: An Outline You Can Use!
- Patient Check-in
- Medicine Sample Closet Rules & Procedures
- Definition of an Encounter
- Questions You Should Ask When Preparing the Cost Report
- Cost Report Basics
- Sole Proprietorship Benefits & Risks
- Productivity Requirements
- Physician Compensation & FTE Issues
- Cost Report Carve-Outs: Types, Requirements & Methods
- Allowable Costs & Payroll Logs
- Non-RHC Costs & Their Impact on the Cost Report
- The Required Lab Tests in the RHC
- Co-Mingling: What Is It?
- Rental of RHC Space
- APC Billing in the RHC & Hospital Management
Session 2: Billing/Reimbursement
- Appropriate for the Billing staff (120 min.)
- !Billing vs Charges: There's a Difference!
- !Charge for What You Do & Document What You Charge For!
- !The UB92: Billing Basics
- !RHC Billing Software: Requirement for Effectiveness
- !Billing Part B: Limitations & How-To
- !Billing for Diagnostic Tests & Lab Services
- Who & What Will Medicare Pay For
- Bundling Your Charges Plus Coding Essentials
- Ways to Maximize Your Reimbursement Rate
- Correct Revenue Codes
- Nursing Home Billing
- Place of Service Requirements
- The Superbill/Charge Slip: Routing, Signatures, etc.
- Billing for the Non-RHC Service
- Bad Debt Collection & Medicare Bad Debt Log
- Flu & Pneumonia Log
- Medical Necessity: The Foundation of all Reimbursement!
- Physicals, Recurrent Services, Disease Management & Lipid Visits
- Pain Management
- Routine Foot Care Visit Reimbursement
- Home Visit, Nursing Home & Family Consult Visits
- Contractual Adjustments for the Medicare Payment
- Non-Billable Service Billing
- The 72-Hour Rule
- Billing for DME
Session 3: Medical Provider Issues
Designed for Physician, NP, PA & CNM (100 min.)
- Charge for What You Do
- Chart Documentation: Critical
- CPT Coding Essentials for the Provider
- Procedures in the RHC
- Can the RHC Have a “Treatment Room” & Bill Medicare Part B?
- Injections in the RHC
- Definition of an Encounter
- Non-Physician Services
- Charging for Injections, Dressing Change, Suture Removal
- Supervision of the NP/PA/CNM
- How Many Patients Per Day Must the Provider See to Make a Profit?
- Provider Signature Requirements
- Medical Director Requirements
- Physician/Owner Issues
- Medical Provider Compensation: Methods, Limitations, Options.
- Medical Necessity: The Foundation of all Reimbursement!
- Diagnostic Tests in the RHC
- Physicals, Recurrent Services, Disease Management & Lipid Visits
- Pain Management in the RHC
- Routine Foot Care Visits & RHC Reimbursement
- Home Visits & RHC Reimbursement
- Nursing Home Visits & RHC Reimbursement
- Family Consultations & RHC Reimbursement
- Ways to Avoid Being Called a Defendant
- Importance of Legible Notes: Written or Dictated
- Electronic Medical Records: How Complicated?
- The Medical Record: Regulatory Requirements
- Fraud Issues
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Special Total Training Set:
All FIVE DVD Products
Price: ($783 Value): $599
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