Continuing Education

Supported by an unrestricted educational grant from Hann's on Software

Sunday, March 1

1:45- 3:15 p.m.

3-A Managing Claim Rejections

 

Faculty: David Franklin, MSA, CEO, VitalCare, Meridian, MI

1.5 Contact Hours
ACPE # 207-999-09-104-L04-P

• Learn how to gain and hold the upper hand when dealing with third party claim denials.
• Identify the legal considerations of insurance claim processing and payment.
• Examine tactical approaches to managing denials, including methods of tracking and trending claim denials.

OBJECTIVES:

1. Identify the basic legal structure applicable to the private sector.
2. Cite tactical approaches to denial management.
3. Describe methods of tracking and trending claims denials.

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Monday, March 2

10:45-11:45 a.m.

7-B Drug Pricing Methodologies

 

Faculty: Alan Parver, Esq, Partner, Powell Goldstein, LLP, Washington, DC

1.0 Contact Hours
ACPE # 207-999-09-112-L04-P

Receive a pragmatic overview of drug pricing and how it affects home infusion specialists, including AWP, HCPCS v. NDC, and product vs. service-based reimbursement. Comprehend the fundamental definition of Average Sales Price (ASP) and investigate related class of trade and transparency issues. Explore the essential elements of the federal 340B Drug Pricing Program to better understand how to comply with its associated inventory management, auditing and tracking requirements, and study additional drug pricing methodologies, such as Wholesale Acquisition Cost (WAC).

OBJECTIVES:

1. Explore historical drug pricing in the alternate site infusion industry.
2. Examine Average Sales Price methodology and impact on infusion reimbursement.
3. State the impact of drug pricing methodologies on the current and future provision of home infusion services.

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3:15-4:45 p.m.

11-C Medicare Part B Coverage of Home Infusion Therapy

 

Faculty: Pamela Dentino-Olson, Corporate Reimbursemant Manager, Walgreen’s/Option Care, Buffalo Grove, IL

1.5 Contact Hours
ACPE # 207-999-09-116-L04-P

• Understand how Medicare Part B benefits apply to home based services.
• Learn the coverage criterion, coding and documentation requirements, billing and appeals processes for Medicare Part D claims.
• Acquire valuable insight into recent and anticipated program changes.

OBJECTIVES:

1. Recite the applicable benefit categories related to home infusion.
2. Identify applicable coverage criterion by therapy type.
3. Describe the Medicare appeals process.

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Tuesday, March 3

10:45-12:15 p.m.

15-D The Revenue Cycle: Tighten the Nuts and Bolts to Ensure Prompt Payment and Accurate Reimbursement- Part 1

Faculty: Linda Payne, President, Reimbursement Concepts, LLC, Weirton, WV

1.5 Contact Hours
ACPE # 207-999-09-124-L04-P

• Discover the critical components of the revenue cycle—and valuable strategies for assuring accurate billing and revenue recognition, starting with file set-up and maintenance.
• Grasp proven methods for improving front end intake processes to better secure prompt payment.
• Analyze various best practices in billing—and discuss how to successfully apply these approaches at your alternate-site infusion organization.

OBJECTIVES:

1. Discuss how file set up and maintenance play a critical role in ensuring accurate billing and revenue recognition.
2. Identify proven strategies that improve your front end intake process to ensure prompt payment.
3. Describe billing best practices.

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2:45-4:15 p.m.

19-E The Revenue Cycle: Tighten the Nuts and Bolts to Ensure Prompt Payment and Accurate Reimbursement- Part 2

Faculty: Linda Payne, President, Reimbursement Concepts, LLC, Weirton, WV

1.5 Contact Hours
ACPE # 207-999-09-128-L04-P

• Investigate demonstrated collection strategies and tools that reduce Days Sales Outstanding (DSO).
• Understand how to utilize productivity monitoring and management reports to improve billing and collection performance.
• Examine best practices for staying current with industry changes and technological solutions.

OBJECTIVES:

1. Describe proven collection strategies and tools that will reduce days sales outstanding
2. Understand how to use productivity monitoring and management reports to improve billing and collection performance
3. Discuss best practices for keeping up to date with industry changes and technological solutions

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4:30 -5:30 p.m.

23-F Surviving Audits

 

Faculty: Linda Czekanski, Business Improvement Manager, Air Products Healthcare, Conshohocken, PA

1.0 Contact Hour
ACPE # 207-999-09-132-L04-P

• Identify the types of reimbursement audits that home infusion providers face.
• Develop strategies that will assist you in preparing for, and surviving, each type of audit.
• Understand your options post-audit, from the receipt of notice through the appeals process.

OBJECTIVES:

1. Identify actions needed based on the type and conditions of the audit.
2. List the challenges associated with an audit.
3. Describe how to present the requested documentation.

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Wednesday, March 4

9:15- 10:45 AM

27-G The Latest in Successful Self-Pay Collection Techniques

 

Faculty: Lisa Bargmann, BS, MBA, Chief Executive Officer, Bargmann Management LLC d/b/a Homecare Collection Service, Akron, OH

1.5 Contact Hours
ACPE # 207-999-09-138-L03-P

Patient pay collections are arguably one of the most difficult avenues of revenue to gather. This presentation will review the factors that must all converge to drive successful collections, including:

• An understanding of current collection law and regulations, at both the national and state levels;
• Hiring and training personnel to manage the collections process with tact and skill;
• Proven techniques to increase timely self-pay collections

OBJECTIVES:

1. Learn how and when to speak to patients regarding their self-pay obligations
2. State the purpose and basic premise of collection laws governing patient pay activities.
3. Demonstrate techniques for managing the self-pay collection process.

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11:00-12:00 p.m.

31-H Medicare Part D Operations

 

Faculty: Joe Carter, RPh, Pharmacy Manager, Accredo Health Group, Warrendale, PA; Vicki Wilson, Regional Director of Reimbursement, Air Products Healthcare, Conshohocken, PA

1.0 Contact Hours
ACPE # 207-999-09-142-L04-P

• Understand the nuts and bolts of billing Medicare Part D, beginning with management of the referral and verification of patient eligibility;
• Identify effective methods of communicating with the patient and physician regarding coverage options and gaps;
• Review Medicare Part D covered drugs, formularies, flushes and diluents with a goal of receiving accurate reimbursement that reflects the care and services being provided.

OBJECTIVES:

1. Describe the Medicare Part D benefit, including the role of PBMs (Pharmacy Benefit Mangers).
2. List training requirements and delineate responsibilities across staff.
3. Describe the necessary communication between all involved parties.

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2:00-3:00 PM

35-I Solving Reimbursement Killers!

 

Faculty: Julie Runyon, Regional Vice President PFS Western Region, Coram, An Apria Healthcare Company, Sacramento, CA; Bryan Briley, Regional Vice President PFS Central Region, Coram, An Apria Healthcare Company, St. Louis, MO

1.0 Contact Hours
ACPE # 207-999-09-147-L04-P

• Identify the internal and external issues that are preventing your organization from receiving payment for goods and services
• Learn how to mitigate the challenges that stand in the way of your company being paid what you are owed.
• Take home a strategic plan for reimbursement processes that proactively strive for payment

OBJECTIVES:

1. Verbalize how to identify and resolve external causes of non-payment of claims.
2. Verbalize how to identify and resolve internal causes of non-payment of claims.
3. List strategies to prevent non-payment of claims.

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