Billing/Coding: Best Practices (part 1); Navigating the Maze (part 2) (1231)
89 minutes
1.4 Contact Hours / ANCC
Part 1 - Best Practices for Hospice and Palliative Care: It’s clear that the Medicare program is paying more attention to services billed by hospice and palliative care providers. And, as all government budgets tighten, it should not be surprising that the Medicare program will continue to look for potential overpayments through the audit process. This session provides a discussion of compliance concerns and best practices.
Part 2 - Navigating the Maze of Physician Billing: Billing for physician patient care services can be very complex. An incomplete understanding of billing can lead to not only loss of revenue for your hospice but pose a significant compliance risk. Properly documenting a patient’s visit using the three key components and knowing when and how to document using time continues to be a challenge for physicians and nurse practitioners. These basics are covered in-depth to help ensure that (1) third-party payers are not successful in retrospective recoupment, and (2) your hospice or palliative care program optimizes the revenue potential of physician services.
Objectives
- Describe the circumstances that allow physician visits to be separately billable.
- List common pitfalls made by providers in hospice and palliative care.
- Differentiate the hospice benefit from billable physician services.
- Discuss how to substantiate the medical necessity of physician visits through thorough documentation.
- Summarize the 1995 evaluation and management guidelines.
- Outline Medicare's position on "Family Meetings."
- Distinguish time-based billing/coding from billing/coding on "complexity."
- Develop a general understanding of the documentation required to substantiate physician billing.