EDUCATION SERIES: Getting to the Heart of Revenue Integrity

June 12, 2018
8:00 AM - 4:30 PM
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Pines Manor
2085 Lincoln Highway
Edison, NJ 08817
http://www.pinesmanor.com/
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7:30am – 8:20am       Registration and Breakfast

8:20am - 8:30am        NJ Revenue Integrity Forum Introduction and Kickoff 

8:30am - 8:40am        NJHA Update 

8:40am - 9:00am        Welcome - Induction of Officers and Announcements of Scholarship Recipients 

9:00am - 10:00am      Got AED? Reviving the Relationship between Pharmacy and Finance Teams 

This session will give participants an overview of the Finance and Pharmacy relationships, best practices for collaboration and highlight key areas for focus to enhance the business of the pharmacy department.

Session Objectives: 

  • To understand the importance of the pharmacy business model and its impact on overall hospital finances
  • Highlight the revenue cycle disconnect between Finance and Pharmacy
  • Understanding drug reimbursements, changes, and challenges
  • Highlight strategies and best practices to handle the changing environment surrounding medications

Presenter: 

Craig W. Dolan, RPh, PharmD, MBA
Vice President, Advisory Services
McKesson RxO

10:00am - 10:15am    Break

10:15am - 11:15am    Chain of Survival: Keeping your Rhythm regular to Common Supply Chain Issues 

A successful supply chain program demands an alignment of various players working together to create a plan that works for their specific organization. This session will focus on identifying common challenges encountered in healthcare supply chain today.

Session Objectives: 

  • Process tips for synchronizing charge master to item master to improve revenue stream
  • Assess the current challenges related to hospitals’ surgical inventory services
  • Demonstrate how Lean methodologies can be applied to assist with pack revisions and version updates
  • Develop a process for managing vendor owned trunk stock
  • Provide one improvement technique participants can take back to their facilities to promote supply chain excellence
  • Discuss the process of trailer billing including Payer audits and how contract language can optimize reimbursement

Presenters:

Lisa Tonkinson
Principal
Leonard Consulting           

Donna Heringes
Manager, Managed Care
Penn Medicine Princeton Health

Jane Hoffman
Contract Management Specialist
Penn Medicine Princeton Health

11:15am - 12:15pm    HeartBytes: Role of Analytics in Revenue Integrity

This presentation details how data analytics are used to optimize revenue.       A case study will be presented to help attendees understand analytical techniques for optimizing revenue. Takeaways will include examples of analytical approaches institutions can use internally.

Session Objectives:

  • Describe how big data can be used to assist revenue integrity initiatives
  • Review one healthcare organization’s journey through revenue integrity analytics
  • Identify key strategies used for revenue integrity-both successes and missed opportunities
  • Provide attendees with tools and ideas to obtain the same success within their revenue integrity initiatives

Presenters:

Mr. Jeff Clayton
Vice President/Principal
McBee Associates, Inc.

Mr. Mitchell Schwartz
Manager
McBee Associates, Inc. 

12:15pm - 1:00pm     Lunch

1:00pm - 2:00pm        Prevent Sudden Cardiac Arrest: Post-Claim Analysis…Making Your Claim Data Work for You                                                 

This session will present best practices to achieve clean claims, correct coding, compliance, and an educated, cohesive revenue cycle-operational-clinical team. Attendees will utilize Lean principles to examine claims analysis strategies and responsibilities.

Session Objectives:                                                 

  • Consider best practice strategies for compliant claims, accurate charges, reduced audits/denials, and identifying missed revenue opportunities
  • Identify strategies to achieve buy-in, accountability, and partnership with key operational and clinical stakeholders to improve charging and documenting habits, and claims success
  • Utilize SIPOC (Supplier, Input, Process, Output, Customer) diagramming to focus on the inputs and outputs of a claims analysis process and identify value-added activities
  • Develop RACI (Responsible, Accountable, Consulted, Informed) matrix to identify the various tasks associated with a claims analysis process, determine the necessary roles (people, groups, departments), and assign responsibilities

Presenters:    

Kerry Topper, RHIA
Manager of Revenue Integrity
Beebe Healthcare

Sharon B Kesterson, CPA
Director of Patient Business Services                                   
Beebe Healthcare

Lauren Strong
Billing Manager
Beebe Healthcare

Veronica Anzalone, RN
Marketing Manager, Lean Leader
Craneware

2:00pm - 3:00pm        Protect This Heart: Emerging Payer Coding & Medical Policies that Impact Hospital Reimbursement

New payer coding and medical coverage policies results in an increase of Experimental and Investigational Denials and Non-Emergent Denials.  This session will provide strategies and resources hospitals can use to overcome these high volume complex denials.

Session Objectives:                                                 

  • Discern relevant clinical documentation, contract provisions, New Jersey state statutes, and court decisions that can be used to address these denials
  • Provide resources to utilize in a denial management process, such as appeal letter templates, spreadsheet of relevant New Jersey Statutes and Regulations, and summary of applicable Federal legislation
  • Provide successful strategies used at one facility that can be implemented by attendees at their facilities

Presenters:                                               

Tracy Lutz, Esq
Managing Partner
Specialized Healthcare Partners

Diane Crowl-Schwarz, RN, BSN, MBA
Director, Medical Audits
AtlantiCare Regional Medical Center 

3:00pm - 3:15pm        Break

3:15pm - 4:15pm        Heartsavers: Breaking Down Silos to Mitigate Denials 

This panel will address how better information flow and coordination between hospital departments can ultimately result in fewer denial write offs.  

Session Objectives: 

  • How to prevent, track and respond to denials
  • How to write payer contracts to protect against denials
  • Discuss the importance of sharing findings with advocacy agents such as hospital associations
  • Implement a multi-pronged approach to preempt complex claim issues
  • Encourage collaboration between internal and external revenue cycle entities

Panelists:

Annie Akkara, MD
Physician Advisor                                   
FairCode Associates

Carleton Baler, MD, JD  
Lead Physician Advisor
RWJ Barnabas Health – New Brunswick

Diane Crowl-Schwarz, RN, BSN, MBA
Director, Revenue Integrity                                   
AtlantiCare Regional Medical Center

Theresa Edelstein, MPH, LNHA 
Vice President, Post-Acute Care Policy & Special Initiatives
New Jersey Hospital Association 

Tracy Lutz, Esq
Managing Partner
Specialized Healthcare Partners

Vickie McElarney, RN, MBA, FACHE, COC (Moderator)  
Consultant
Craneware 

4:15pm - 4:30pm        Closing


EDUCATION CREDITS 

NEW JERSEY BOARD OF ACCOUNTANCY CONTINUING PROFESSIONAL EDUCATION CREDITS

Based on our understanding of the New Jersey State Board of Accountancy’s continuing professional education (CPE) requirements, Sponsor No. 185, this course is currently approved for 7.0 CPE credits.

AMERICAN COLLEGE OF HEALTHCARE EXECUTIVES CONTINUING EDUCATION CREDIT

The New Jersey Chapter of the Healthcare Financial Management Association is authorized to award 6.0 hours of pre-approved Category II (non-ACHE) continuing education credit for this program toward advancement, or recertification in the American College of Healthcare Executives.  Participants in this program wishing to have the continuing education hours applied toward Category II credit should indicate their attendance when submitting application to the American College of Healthcare Executives for advancement or recertification. 

AMERICAN ACADEMY OF PROFESSIONAL CODERS CONTINUING EDUCATION CREDIT

CEU’s are currently approved for 6.0 AAPC credits.

SUPREME COURT OF NEW JERSEY BOARD ON CONTINUING LEGAL EDUCATION

Based on our understanding of the Supreme Court of New Jersey Board on Continuing Legal Education mandatory continuing legal education program requirements, this course will qualify for 7.0 CLE credits. NJ HFMA is an approved service provider (#1098).


REGISTRATION INFORMATION:

  • Registration is available online at www.hfmanj.org or by mail.
  • Make checks payable to HFMA - NJ CHAPTER, and please mail at least 10 days prior to the event.
  • Registration must be received three working days prior to the event.
  • REFUNDS WILL BE GRANTED ONLY IF CANCELLATION IS RECEIVED 48 HOURS PRIOR TO THE MEETING.
  • Dress is Business Casual.
  • Mail payment to:            

HFMA – NJ Chapter  
Laura Hess
P.O. Box 6422
Bridgewater, NJ08807

  • Phone number for questions is (908) 963-2505.

Tickets

$135.00 ADVANCE REGISTRATION - MEMBERS
$160.00 after 05:00 am June 12

$160.00 ADVANCE REGISTRATION - NON-MEMBERS
$185.00 after 05:00 am June 12

$100.00 ADVANCE REGISTRATION - CERTIFIED MEMBERS (FHFMA, CHFP)
$125.00 after 05:00 am June 12

$35.00 STUDENT REGISTRATION
$60.00 after 05:00 am June 12

$135.00 ADVANCE REGISTRATION - MEMBERS FROM OTHER CHAPTERS
$160.00 after 05:00 am June 12

$500.00 Vendor Table - includes 2 attendees

$300.00 Vendor Admission - $300 with separate $200 charitable donation payable to Simon's Heart (please bring $200 check made out to Simon's Heart to the event)

Documents

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