Avoiding Reimbursement Risk in your Emergency Department

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Emergency Departments are a critical setting for care within our communities, and they have to be prepared at all times.  Making sure reimbursement is complete and accurate becomes increasing important, especially during a global crisis. In addition to the already heavy burden placed on Emergency Departments, there is a worrisome trend of increased scrutiny of Facility Visit Levels and increasing reimbursement risk. For each patient who enters your Emergency Department and are safely discharged home after treatment, there are vital steps you can take to ensure you are paid appropriately for the care delivered.

It can be virtually impossible to keep up with changing payer requirements, new regulations, and other challenges surrounding Facility Visit Levels.  Facility Visit level assignment and charging has risen to the top of the list when evaluating the cost of outpatient care. Consistent and accurate charging in the ED can reduce your risk potential and streamline the path to improved financial reimbursement in the Emergency Department.

Promise of relief can come from technology that can bring innovation and information when and where it’s needed. During this session on Thursday, July 16th at 1 pm ET, Amanda Hofer of Optum will discuss trends shaping Emergency Department reimbursement and how to protect your revenue and reduce your risk.

Learning Objectives:

  • Learn trends and pressures that have effected reimbursement in the Emergency Department
  • Discover how applying unique intelligence into your technology can improve efficiency and address the negative forces on reimbursement.
  • Hear three best practices for Emergency Department reimbursement.

Telehealth: Revamping the Patient Journey | 3 Perspectives

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To retain current patients and grow their customer base, it’s time health systems move addressing the customer experience to the top of the priority list. Access, convenience, and cost have long been driving factors in care decisions, but with the rapid adoption of virtual care, we’ve added new channels and touchpoints to the customer experience. If all we do is tack it onto the existing healthcare journey, we’re missing an important inflection point.

Plainly stated: Competition is on to attract healthcare consumers who are now much more comfortable with virtual care than they were less than six months ago. Just like when adding a new service or building a new specialty center, the idea of “build and they will come” is a false narrative.

Join us on Wednesday, July 8th at 1 pm ET, to hear the perspectives from experts of OHSU, Nemours Children’s Health System, and Healthgrades on

  • Expanding market reach and audience targeting through improved data insights and go-to-market strategies
  • Creating a more seamless connection between virtual care and brick-and-mortar visits, and
  • Building stronger relationships, improving patient engagement, and retaining more customers with a sophisticated approach to telehealth

Optimal Financial Reimbursement & Quality Performance in Today’s Environment

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As costs increase, revenue streams dwindle, and elective surgeries continue to lag, it’s critical to accurately reflect the complete patient story and the care delivered. The current environment affects your bottom-line in newfound ways and you need to ensure you are reimbursed for every available dollar for services rendered. 

Join us on Thursday, June 25th at 1 pm ET, as we share strategies you can employ to make sure you are optimizing revenue opportunities now and post-pandemic.

Learning Objectives:

  • Better understand the current landscape related to your CMI and Quality Scores
  • Hear four strategies to employ to ensure all reimbursable amounts are identified
  • Learn how to maintain your coverage of CDI to all Payers as elective surgeries resume

Nurse Retention: Statistics and Strategies

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A high nurse turnover rate can be costly to healthcare organizations due to excessive training costs and overtime pay. Additionally, a high nurse turnover rate lowers morale of nurses and healthcare staff on the floor and contributes to burnout.

Join us on Wednesday June, 24th at 3 pm ET for this 60-minute webinar where Sylette DeBois, DNP, MSN-Ed, RN, will provide attendees with the data and practical solutions to boost their organizations’ nurse retention.

At the conclusion of this webinar, participants will be able to:

  • Recognize the effects of nurse turnover for the organization
  • Identify the contributing factors that exacerbate nurse turnover
  • Identify the strategies to reduce nurse turnover

Managing in the Era of COVID-19: A Health Plan’s Perspective

COVID-19 is having a profound impact on the delivery of healthcare, but how is it affecting healthcare business strategies such as payment integrity initiatives while enhancing provider and member experiences? For health-plans delivering pandemic related messages to members – success depends on timeliness, and the ability to effectively help members navigate their healthcare and benefits remotely. Health plans must address the needs of providers while still maintaining critical cost efficiencies processes.

Join us for a virtual fireside chat with Dr. Craig Samitt, CEO BlueCrossMN, and Sorin Davis, SVP Industry Relations CAQH, on June 11th at 1:00PM to discuss these and related issues and learn:

• How payers are achieving relevant and improved operational efficiencies in payment integrity (PI) initiatives in the COVID-19 era.
• What are top trends among health plans for sustaining critical payer integrity initiatives during COVID-19.
• How health plans are managing provider and member abrasion while still maintaining cost containment process efficiencies.
• What role an effective COB strategy can play in impacting PI initiatives during COVID-19.
• How health plans are establishing priorities for PI program investments?

Meeting the Needs of Complex Patient Populations Through Care Collaboration

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Collective Medical

As we approach a post-pandemic world, providers are facing sudden spikes in patients with behavioral health conditions and substance use disorder—many of which also have social determinants of health (SDOH). 

Providing meaningful care for these patients in the wake of COVID-19 requires a full, collaborative, community effort.

Join us on Tuesday, June 2nd 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 their actionable—and proven—best practices for establishing and developing community partnerships to support patients struggling with complex comorbid physical, behavioral, mental, and SDOH challenges.

Learning Objectives:

  • Learn how real-time updates and community collaboration effectively and efficiently deliver a complex, high-risk patient population the diverse services they require—at a lower cost and with higher quality outcomes
  • Show how intervention within the emergency department can reduce ED use for behavioral health patients by 76% and increase patient engagement in community behavioral health programs by 150%
  • Understand the unique challenges facing providers who manage patients with complex physical, behavioral, mental, and social determinants of health needs as we move into a post-pandemic world