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Agenda (subject to change)

April 30, 2018


 7:30 - 8:30 AM  Registration
 
 8:30 - 8:40 AM  Opening Remarks 
 Lisa Banker, MD
 Vice President, Chief Physician Advisor,
 McLeod Health System
 
 8:40 - 9:00 AM  Burning Platforms for ACPA    Edward Hu, MD, CHCQM-PHYADV
 System Exec Director, Physician Advisor Services
 UNC Health Care System
 9:00 - 10:00 AM  Fire Starters for the Physician Advisor
  • Basic skill sets
  • Medicare A, B, inpatient, observation
  • 2 Midnight Rule, CC44, HINNs
   Pooja Nagpal, MD, CHCQM-PHYADV 
 Physician Advisor, St. Joseph Health
 10:00 - 10:45 AM  Proprietary Screening Tools - A "Meeting" of the Minds
 on Status Decisions
 


 William Rifkin, MD
 Managing Editor, MCG
 Hearst Healthcare Network




 Robert Roth, MD
 Medical Director, Level of Care Products
 Change Healthcare (InterQual)



 Steve Silverstein, MD
 Vice President, Chief Clinical Architect
 Change Healthcare (InterQual)
 10:45 - 11:00 AM  BREAK    
 11:00 - 11:45 AM  Interdisciplinary Rounds - Keeping Feet to the Fire                 
  • How rounds are structured
  • Who participates
  • Benefits realized
   Howie Stein, DO, CHCQM-PHYADV
 Physician Advisor, CentraState Medical Center
 11:45 - 12:30 PM  Case Management in the ED - Up Front Ignition
  • The case for ED case management
  • Operations and obstacles
   Day Egusquiza
 President, AR Systems, Inc
 12:30 - 1:00 PM  WORKING LUNCH     
 1:00 - 1:50 PM  Documentation Integrity Fuels Everything
  • Importance of documentation
  • How to get physician engagement
  • Understanding the relationship with coding
   Trey LaCharite', MD, FACP, SFHM, CCS, CCDS
 Medical Director, CDI and Coding
 University of Tennessee
 1:50 - 2:40 PM  Observation - The Art of Churn and Burn
  • How observation medicine is different
  • How an observation unit should operate
  • What do you measure?
   Juliet B. Ugarte Hopkins, MD, CHCQM-PHYADV
 Physician Advisor, ProHealth Care
 2:40 - 3:00 PM  BREAK     
 3:00 - 3:50 PM  Quality - A Many Splendored Thing                                         Nick Ulmer, MD, CPC
 Vice President, Clinical Services
 Spartanburg Regional Medical Center
 3:50 - 4:40 PM  Burning Questions Panel    Pooja Nagpal, Juliet B. Ugarte Hopkins, Howie Stein
 4:40 - 5:00 PM  Closing Comments
 Day One Evaluations 
   


May 1, 2018


 7:15 - 8:00 AM  BEST PRACTICE BREAKFAST SESSIONS
 
 8:00 - 8:10 AM  Opening Remarks 
 Lisa Banker, MD
 Vice President, Chief Physician Advisor
 McLeod Health System
 8:10 - 9:00 AM  We Like it Hot - Let's Add Some PEPPER
  • Understand purpose and structure of PEPPER report
  • How to act on the report
   Ronald Hirsch, MD, CHCQM-PHYADV
 Vice President, R1 Physician Advisor Services
 9:00 - 9:50 AM  CDI Conundrum Diagnoses
  • Frequent and problematic diagnoses
  • How precise documentation can defend against denials
   Tim Brundage, MD, CCDS
 President, Brundage Medical Group
 9:50 - 10:10 AM  BREAK    
 10:10 - 11:10 AM  UM Committees Keep the Fires Burning
  • Structure of the UM Committee
  • Operationalizing the UM Committee
  • Reducing costly clinical variation
 
 Bart Caponi, MD
 Medical Director, UR & Case Management
 University of Wisconsin




 Edward Hu, MD, CHCQM-PHYADV
 System Exec Director, Physician Advisor Services
 UNC Health Care System
 11:10 - 12:00 PM  Peer to Peer and Medicare Advantage Plans
  • Differences between MA plans and Medicare FFS
  • Strategies for MA plan denials
  • Improving relationships with MA medical directors
   Brian Moore, MD, FACEP, CHCQM-PHYADV
 Medical Director, Utilization Management and
 Physician Advisor Services
 Carolinas HealthCare System
 12:00 - 12:30 PM  WORKING LUNCH
   
 12:30 - 1:15 PM  Mission Creep:
The Physician Advisor and Payer Contracts
  • Understand the importance of contracts
  • How a physician advisor can be helpful
  • Understand how HCCs can be useful in negotiation             

 
 Jessica Gustafson, Esq.
 Health Law Partners

 


 Elizabeth Lamkin, MHA
 President, PACE Healthcare
 1:15 - 2:00 PM  Denials Scene
  • RAC focuses, present and future
  • Current state of the ALJs
 
 Jessica Gustafson, Esq.
 Health Law Partners




 Abby Pendleton, Esq.
 Health Law Partners
 2:00 - 2:45 PM  Sparking an Overturn - Tips on Fighting Denials
  • Practical advice on strategic approaches
  • Pitfalls to avoid
   Lisa Banker, MD, FACP, CCS, CCDS
 Vice President, Chief Physician Advisor
 McLeod Health System
 2:45 - 3:00 PM  BREAK     
 3:00 - 4:00 PM  Finance 101 for the Physician Advisor  
 Sandy Wolskill, FHFMA
 Director, Healthcare Finance Policy, Revenue
        Cycle



 Chuck Alsdurf, CPA
 Director, Healthcare Finance Policy, Operational
        Initiatives
 4:00 - 4:45 PM  Burning Questions Panel    Brian Moore, Elizabeth Lamkin, Sandy Wolskill         
 4:45 - 5:00 PM  Closing Comments
 Day Two Evaluations
   


May 2, 2018


 7:15 - 8:00 AM  BEST PRACTICE BREAKFAST SESSIONS
 
 8:00 - 8:10 AM  Opening Remarks 
 Lisa Banker, MD, FACP, CCS, CCDS
 Vice President, Chief Physician Advisor
 McLeod Health System
               
 8:10 - 9:00 AM  The Two Midnight Rule and Short Stay Reviews
  • How physician documentation can be improved
  • New developments in CMS directed short stay reviews
  • Case examples and interpretation
   Ferdinand Richards III, MD                                        
 KEPRO, Chief Medical Officer
 9:00 - 9:50 AM  Seeing Through the Smoke - What's Coming?
  • Overview of future plans for the auditors
  • How a physician advisor can help to ease the denial burden
   Ronald Hirsch, MD, CHCQM-PHYADV
 Vice President, R1 Physician Advisor Services
 9:50 - 10:10 AM  BREAK    
 10:00 - 12:00 PM  Faculty Case Discussion Panel    Edward Hu, MD, CHCQM-PHYADV
 Ronald Hirsch, MD, CHCQM-PHYADV
 Brian Moore, MD, FACEP, CHCQM-PHYADV
 Juliet B. Ugarte Hopkins, MD, CHCQM-PHYADV
 12:00 - 12:10 PM  Closing Comments
 Final Evaluations