Agenda

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In this session, we will review the definition of medical necessity as it relates to Medicare, Medicaid, and commercial insurance carriers. The objective of this course is to “relearn” the meaning of medical necessity and how working with physicians promotes greater insight. During the presentation, we will discover resources for medical necessity guidance and regulations. We will also discuss peer review and how this relates to medical necessity within the healthcare field.

This timely presentation delivers an update about new privacy and security rules, guidance and regulatory changes. These new rules are related to the ONC Information Blocking and CMS Interoperability and Patient Access rules based on the 21st Century Cures Act which has many dimensions that may be addressed depending on implementation dates and industry trends.

The presentation is intended to impart a large volume of information about the rapidly changing regulatory privacy and security environment in a relatively short timeframe with comprehensive slide content useable by attendees after the presentation as they adopt and train others on these subjects. Mr. McLendon is well known for condensing and simplifying the complex presentation content into easily learnable points with his signature delivery style.

Topics such as how patient access and exchange of patient information is affected by information blocking and interoperability for Providers, Payers, HIEs, HINs. Other topics that may be included are how patients should be educated about Mobile Health Apps, the importance of designated record sets and EHI, information blocking exceptions, etc.

This presentation provides an overview of the importance of diversity, equity, and inclusion in an organization, assists participants in understanding what shapes our worldview, and provides strategies to be more inclusive in our practices.

• Define diversity, equity, and inclusion
• Understand the importance of DEI in the workplace
• Understand how dimensions of our own identity shape our worldview
• Identify strategies to engage in inclusive practices

This presentation will review ways to measure employee job satisfaction along with relevant statistics, strategies to address issues related to job satisfaction, and unique telework approaches that engage as well as motivate employees working virtually.

This session will highlight the less visible impacts of COVID in the healthcare industry, such as emerging healthcare delivery methods, coping with restrictions, strengthening of communities, evolving acceptance of electronic communications.

Attitude is a viewpoint, a mindset, a habit. It’s a choice we make every moment of every day. We need your help to brainstorm the indicators, barriers, benefits, and strategies for cultivating an upbeat approach in our quest to make a positive difference.

Objectives:

• Brainstorm Indicators of a Negative Attitude vs a Positive Attitude
• Discuss Barriers and Benefits of a More Positive Attitude
• Create Your Intentional Action Plan of Strategies for a More Positive Attitude

Health care innovations are revolutionizing the patient experience. From interactive health apps inspiring healthy behaviors to the use of telehealth improving safety and reducing stress for patients and staff, to robust patient self-service options that improve patient flow and reduce wait time, healthcare organizations are able to enhance the patient experience through the use of innovative technology.

The pandemic has spearheaded these efforts to improve patient satisfaction while limiting the face-to-face interaction between patients and hospital staff. However, the patient access department has struggled to pivot its workforce into a remote setting with the use of restrictive legacy technology.

The health care landscape has continued to evolve, even more so, due to the pandemic. One thing is clear: patient access is becoming virtual. Health care organizations need to find ways to increase their patients’ access to care while decreasing overall health care costs. Even more so, once the pandemic is regulated, patients will still demand to receive care from their homes. Patients will expect the simplicity and security of virtual visits. This demand will continue to rise. Health care organizations will need to continue to incorporate secure telehealth technology into their business operations.

The evidence is clear, we can expect patient access post-pandemic to change. Previously, the focus was on traditional metrics such as referral management, appointment wait times, capacity utilization, and new patient growth. Now, health care organizations will need to implement an integrated, virtual patient access solution to increase cash, convenience, and patient loyalty in a way that will drive market share and reduce administrative costs.

• Provide an overview of telemedicine coding and documentation requirements.
  • Medicare Telehealth Visits
  • Time – E/M Documentation Criteria
  • Communication-Based Technology Services
  • Billing Modifiers
• Discuss current federal telemedicine waivers and Alabama state-specific waivers.
• Review best practices for auditing and monitoring telemedicine coding and documentation.

HHS has proposed a comprehensive amendment to HIPAA through the federal government rulemaking process, titled “Proposed Modifications to the HIPAA Privacy Rule To Support, and Remove Barriers to, Coordinated Care and Individual Engagement.” If finalized in its current form, this amendment would have far-reaching and immediately significant effects on health care providers in complying with requests for medical record information. Join us to learn the potential financial effect the proposed amendment would have on ROI, including the cost shift from commercial requestors of health information to health care providers. During this session, we’ll review detailed statistics regarding ROI, health information exchange, and the financial model surrounding the process and business.

• Understand the workings of the revenue cycle
• Understand how clinical and non-clinical impact the rev cycle
• Identifying common issues with easy fixes
• Understand why communication matters in the rev cycle

Reporting on data and being a data analyst requires different but shared skillsets. Understanding the difference allows a person to not only interpret the information presented with more accuracy but also identify opportunities where the story can be improved so future decisions can be strengthened.

In this session, we will walk through some dashboard examples that not only assess your current analytic skills but also identify how you can develop other skills necessary to be the best data sleuth in healthcare.

We will begin our journey by uncovering why it is important to identify the real purpose and discover why it truly matters. People sometimes ask for things because they have a goal or a problem to solve, which may not really be the root cause, just the most recent fire they are trying to extinguish. Uncovering the true goal and how that relates to the bigger picture is a skill, and it takes additional skills, such as mapping, grouping, and workflow analysis to truly dive deeper than the superficial ask. Rolling up your sleeves and digging into the ‘behind the scenes’ story transforms a report filled with discrete and continuous data elements in different graphs for one purpose into a pathway of insights for different users who rely on the same data for different problems where all users can see how the data relates.

Knowing where to start is the hardest part but understanding that analytics is not a linear path helps! No matter where you enter on the journey, you can always pivot if you set the realistic expectation ‘data is messy.’ In order to report on healthcare data (or any data), someone has to transform it and someone has to clean it up. Fully understanding your topic prevents you from the ‘data trap’ mindset that the data is correct or what you see is the ‘source of truth.’ The statistician George Box said ‘All models are wrong but some are useful,’ which can be applied to analytics as well because of the limitations we have due to use/application of technology, laws/regulations, and differences between implementations of regulations/standards, which can vary across organizations and settings.

All of this combined can impact how a person views the data that is reported. As a data sleuth and analytic expert, it is important to unravel the complexities of what lies underneath. Come join us and learn how you can identify the complexities of using data to tell a story and what to do when you come across a cryptic story.

Discover the top trends in disclosure management to watch in 2022. Further roll-out of the 21st Century Cures Act, the proposed modifications to the HIPAA Privacy Rule along with a hybrid workforce and the growing increase in digital requests and delivery will all have a direct impact on HIM operations and require organization-wide changes in 2022. Verisma subject matter experts will share first-hand knowledge and steps they are taking to prepare for these challenges and help health system clients navigate through these changes. Learn what areas will see the biggest impact and recommended next steps to take to your organization.

Learning Objectives:

1. Learn what HIPAA changes will directly impact HIM ROI operations and what you can do to prepare.
2. Learn how to ensure compliance with the further rollout of the 21st Century Cures Act to ensure the entire medical records is made available to patients upon request.
3. Learn how technology advances in ROI can help meet the demands the new changes will place on ROI operations.