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  • This session will briefly overview the 5 OIG healthcare risk areas, including the False Claims Act, Anti-kickback Statute, Civil and Monetary Penalties, Exclusions, and the Stark Law.
  • Discover the areas commonly denied and at risk of violating the False Claims Act. This includes medical necessity of admissions and services, unbundling and improper coding and modifier assignment, double billing, billing for services not provided, upcoding, and billing non-covered services as provided.
  • Walk away with resources available to identify what the OIG is targeting and internal resources that facilities can utilize to identify and mitigate hospital-specific risks.
  • Learn about the factors to consider when determining the need to involve legal counsel.
Revenue Cycle Management

Author:

Jill Sell-Kruse

Director, Compliance Risk & Oversight Ethics & Compliance
ScionHealth

Jill Sell-Kruse

Director, Compliance Risk & Oversight Ethics & Compliance
ScionHealth
 

Jill Sell-Kruse

Director, Compliance Risk & Oversight Ethics & Compliance
ScionHealth

Jill Sell-Kruse

Director, Compliance Risk & Oversight Ethics & Compliance
ScionHealth

Jill Sell-Kruse

Director, Compliance Risk & Oversight Ethics & Compliance
ScionHealth
  • Discover how automation in coding reduces manual workloads, increases accuracy, enables compliance, and speeds up the revenue cycle, leading to faster reimbursement and fewer denials.
  • Talk through the challenges of integrating automated systems and how to overcome these. 
Revenue Cycle Management
  • Explore how accurate coding practices can reduce claim denials, enhance reimbursement rates, and streamline revenue cycle processes.
  • Discover actionable ways C-level executives can empower coding professionals to drive better financial outcomes. 
Revenue Cycle Management

Author:

Howard Kung

Senior Director, Revenue Cycle
Mayo Clinic

Howard Kung

Senior Director, Revenue Cycle
Mayo Clinic
  • Explore how AI/ML can streamline denial management processes and drive financial performance.
  • Overcome the challenges of deploying AI/ML by learning actionable steps to help your organization achieve seamless integration and maximise the impact of these tools.
  • Address the elephant in the room. Confront the critical cost vs. outcome debate with an in-depth analysis of key metrics.
Revenue Cycle Management
  • Learn tactics and proven strategies to handle denials effectively and efficiently as they arise.

  • Listen to our expert panel as they provide practical insights on building a robust denials management program, including strategies for categorising and prioritising denials based on financial impact and resolution probability.  

  • Discover best practices for streamlining the appeals process and leveraging data analytics to track, analyse, and optimise your denial management workflows, empowering you to reduce losses and accelerate reimbursement times. 
Revenue Cycle Management

Author:

Paul LePage

Executive Director, Revenue Cycle Operations
Banner Health

Paul LePage

Executive Director, Revenue Cycle Operations
Banner Health

Author:

Betye Ochoa

Director, Revenue Cycle Redesign
NorthShore University HealthSystem

Betye Ochoa

Director, Revenue Cycle Redesign
NorthShore University HealthSystem

Author:

Ebrahim Barkoudah

System Chief & Regional Chief Medical & Quality Officer
Baystate Health

Ebrahim Barkoudah

System Chief & Regional Chief Medical & Quality Officer
Baystate Health

Author:

Brennan John

Director, Revenue Cycle
Intermountain Health

Brennan John

Director, Revenue Cycle
Intermountain Health
 

Ebrahim Barkoudah

System Chief & Regional Chief Medical & Quality Officer
Baystate Health

Ebrahim Barkoudah

System Chief & Regional Chief Medical & Quality Officer
Baystate Health

Ebrahim Barkoudah

System Chief & Regional Chief Medical & Quality Officer
Baystate Health
 

Betye Ochoa

Director, Revenue Cycle Redesign
NorthShore University HealthSystem

Betye Ochoa

Director, Revenue Cycle Redesign
NorthShore University HealthSystem

Betye Ochoa

Director, Revenue Cycle Redesign
NorthShore University HealthSystem
 

Paul LePage

Executive Director, Revenue Cycle Operations
Banner Health

Paul LePage

Executive Director, Revenue Cycle Operations
Banner Health

Paul LePage

Executive Director, Revenue Cycle Operations
Banner Health