Master Ongoing Monitoring Requirements for Credentialing
American Medical Association
April 28, 2020
Once clinicians are credentialed, they are immediately subject to ongoing monitoring for any potential issues. This function is critical to ensure quality care is continually provided to patients but also to ensure that the organization is in compliance with accreditation and regulatory requirements and not subject to fines or other corrective action. This Webinar on Tuesday, April 28th at 1pm ET will provide a focused review of the CMS, TJC and NCQA credentialing requirements for ongoing monitoring along with implementation tips and leading practices that will enable your organization to achieve compliance.
By the end of the Webinar, participants will be able to:
Describe CMS, TJC and NCQA requirements for ongoing monitoring of credentials and performance
Identify appropriate sources to perform ongoing monitoring
List methods and tools to document and track compliance
Participants are encouraged to bring their questions for the closing Q&A session.
Meeting the Needs of Complex Patient Populations Through Care Collaboration
April 16, 2020
Patients with complex physical, behavioral, and mental health conditions—including substance use disorder—pose a unique challenge for providers managing Medicaid beneficiaries. With many of these patients also facing social determinants of health (SDOH), providing meaningful care requires a collaborative community effort.
Join us on Thursday, April 16th at 1 pm ET as Dr. Brian Patel, Chief of Emergency Medicine at Sturdy Memorial Hospital, and Deborah Jean Parsons, Ph.D. Director of Integrated Care at Aspire Health Alliance, share actionable best practices for developing better community partnerships to support patients struggling with complex comorbid physical, behavioral, mental, and SDOH challenges.
Learn how they were able to collaborate with their Massachusetts communities to achieve:
A 150% increase in patient engagement for community behavioral health resources
A 78% reduction in ED utilization for behavioral health patients enrolled in a community program
Lowered care costs for a patient population historically responsible for 50% of statewide Medicaid annual spend
Better overall patient outcomes for those with behavioral health challenges, like SUD, and social determinants of health
Understand the unique population health challenges facing providers who manage patients with complex physical, behavioral, mental, and social determinants of health needs
Summarize the benefits of intervening with complex, high-risk patients within the emergency department and potential obstacles that need to be overcome to obtain engagement
Explain how real-time updates and collaboration can effectively and efficiently deliver a complex, high-risk patient population the diverse services they require—at a lower cost and with higher quality outcomes
As budgets shrink, healthcare organizations are clamoring for more precise data to justify the cost of Clinical Documentation Improvement (CDI) programs, software, and physician time/effort. Current CDI ROI measurement challenges revolve around how to calculate incremental improvement for mature programs. Organizations need to shift their ROI methodology to measure the benefit provided by Computer-Assisted Physician Documentation (CAPD) for each encounter.
During this webinar on Tuesday, March 31st at 1 pm ET learn how to:
Make accurate outcomes a continuous, additive measure of benefit generated from in the moment advice
Engage multiple departmental stakeholders with actionable data
See new opportunities for improvement and expansion within your organization
How AI Improves Documentation and Quality Care in Pediatric and Acute Care Settings
February 20, 2020
Different care settings present unique challenges. In pediatric populations, clinical indicators within the population vary widely depending on the child’s age and developmental stage. Further complicating matters, the guidelines are complex and often subject to discretionary acceptance. In acute hospitals, consistently achieving the types of improvements necessary for value-based care requires a new approach.
In this session on Thursday, February 20th at 1 pm ET, speakers will demonstrate the ways in which AI integrates in workflow to capture appropriate documentation at the point-of-care to guide providers on diagnoses that can automatically query, clarify, document in the medical record to facilitate coding, quality scoring, and accurate clinical communication.
Review the positive quality and financial outcomes of deploying a clinically-focused approach to documentation improvement
Learn how AI can guide providers with diagnoses and treatments and improve clinical documentation and coding at the point-of-care
Takeaway best practices for adopting conversational AI solutions into the documentation workflow at your organization
Join William Jarvis of Bank of America for an interactive discussion on how leading nonprofit healthcare organizations are responding to the reimbursement and business model changes that are taking place in the industry.
The most important investment challenges facing CFOs and CIOs of nonprofit healthcare organizations right now
How changes in the reimbursement environment have affected investment practices
How we define “risk” and the what role it plays in investment practices
How relationships with donors, beneficiaries and the larger stakeholder community influence the definition of success
Strategic Implementation of 2020 Code Changes and their Impact on Compliance
January 15, 2020
Compliance risks can occur at any point in the revenue cycle. The mid-revenue cycle is the point at which clinical documentation improvement, coding, charge capture, prebill reviews, and claims processing occurs. Given the number of processes at this point in the revenue cycle, significant revenue can be lost due to poor practices in any one of these areas. Shoring up the mid-revenue cycle can help mitigate compliance risk due to a failure to adhere to best practices in any of these areas and allow for optimization of revenue and improvements in quality performance. Join us for a detailed discussion of the opportunities for an optimal mid-revenue cycle.
• Understand how tight management of claims on hold for edits and denials is essential to a healthy revenue cycle. • Recognize the importance of engaging physicians in the clinical documentation improvement process. • Identify why it’s important to have payer-specific requirements at the point of claims processing, not at the point of coding. • Understand the updated 2020 ICD-10 and CPT codes and their effect on compliance.