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HomeTLC B


 

 

Course Name:

TLC B

Date of CE Release – 11/01/2020

Date of Last Revision – 11/01/2020

Date of CE Expiration – 11/01/2023

Location – Online


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Non-Members

This Course Contains 7 On-Demand Modules

ACPA members can click on the "Enroll Now" button to purchase. Non-members must first register for a free membership to the ACPA Learning Center by clicking on the "Non-Members" button, then enroll for the course. After enrollment, click here to access the on-demand modules.



ACPA members can click on the "Enroll Now" button to purchase. Non-members must first register for a free membership to the ACPA Learning Center by clicking on the "Non-Members" button, then enroll for the course. After enrollment, click here to access the on-demand modules.




Overview

TLC B is a seven-module course designed to continue the core education for new Physician Advisors which started with TLC A, or solidify the knowledge base for those who are more experienced in the role. Considerations about sepsis, succeeding with commercial plan appeals, pearls about cultivating a high-performing internal Physician Advisor program, specific tools and skills for Physician Advisors working with Pediatric populations, and step-by-step direction about the rules surrounding HINN, IM, DND, ABN, and MOON Medicare notices aim to further your mastery in the field.

Objectives

After attending this program you should be able to understand the structure of Medicare benefits and utilization review, familiarize the learner with the concept of sepsis documentation and set up a basic physician advisor program.



ENROLL NOW ENROLL NOW

Non-Members

After enrollment, click here to access the on-demand modules.


 

Satisfactory Completion

Learners must listen to each self-directed audio recording while following along with the visual slides/read the articles, and complete an evaluation form to receive a certificate of completion. Your chosen sessions must be attended in their entirety. You must participate in the entire activity as partial credit is not available. If you are seeking continuing education credit for a specialty not listed below, it is your responsibility to contact your licensing/certification board to determine course eligibility for your licensing/certification requirement.


Continuing Education Credits

In support of improving patient care, this activity has been planned and implemented by Amedco LLC and American College of Physican Advisors. Amedco LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

Physicians

Amedco LLC designates this material for a maximum of 3.25 AMA PRA Category 1 Credits™ for physicians. Physicians should claim only the credit commensurate with the extent for their participation in the activity.


Acknowledgement

Financial Commercial Support

No financial commercial support was received for this educational activity.

In-Kind Commercial Support

No in-kind commercial support was received for this educational activity.


Disclosure of Conflict of Interest

The following table of disclosure information is provided to learners and contains the relevant financial relationships that each individual in a position to control the content disclosed to Amedco. All of these relationships were treated as a conflict of interest, and have been resolved. (C7 SCS 6.1-6.2, 6.5)


All individuals in a position to control the content of CE are listed in the program book. lf their name is not listed below, they disclosed that they had no financial relationships with a commercial interest.


Name Commercial Interest: Relationship
Denise Goodman N/A
Al Gore N/A
Larry Hegland N/A
Steven Meyerson N/A
Erica Remer N/A
Denise Wilson N/A

Disclaimer of Liability

The American College of Physician Advisors (ACPA) publishes and distributes materials created by our members and speakers for the benefit of all ACPA members. ACPA does not certify the accuracy or authority of these materials. These materials are distributed and presented as research information to be used by ACPA members, in conjunction with other research deemed necessary, in the exercise of ACPA members’ independent professional judgment. Original and fully-current sources of authority should be researched by ACPA members. ACPA disclaims all liability in relation to reliance on the content of these materials. The views expressed in the materials are the views of the material's authors and do not represent the views of ACPA. Any references are provided for informational purposes only and do not constitute endorsement of any sources.



Course Speakers

Larry Hegland, MD, MMM

Dr. Larry Hegland is the System Medical Director for Recovery Audit and Appeal Services for Ministry Health Care. He also serves as Chief Medical Officer for Ministry Saint Clare’s Hospital, Ministry Good Samaritan Medical Center and The Diagnostic and Treatment Center in Weston, Wisconsin. Dr. Hegland received his training as an anesthesiologist at Northwestern University and possesses a degree in Medical Management from Carnegie Mellon University. Dr. Hegland is the Treasurer for the American College of Physician Advisors.

High Performing Physician Advisor Program

Alvin Gore, MD, CHCQM

Utilization Management Director, St. Joseph Health, Sonoma Co.

Dr. Alvin Gore is a Director for Utilization Management at two hospitals at St. Joseph Health. While performing all traditional responsibilities of the Physician Advisor, he is also involved with less traditional duties such as cost of care reduction projects, bundle payments, population health, and full-risk cohort management, as well as CDQI (quality) projects. Dr. Gore is the Vice President of Operations for the American College of Physician Advisors.

Medicare Basics

Steve Meyerson, MD

Dr. Steven J. Meyerson is a nationally recognized expert in care management and physician advisor education. He is an internist and geriatrician by training. He has served as medical director of care management at Baptist Hospital in Miami, FL, as well as SVP of education and regulations at R1 (formerly Accretive) Physician Advisory Services. He currently heads SJM Consulting, a Medicare compliance consulting firm. For his distinguished service to physician advisors for many years, he received the inaugural ACPA Lifetime Achievement Award in 2015. He currently lives with his wife in Asheville, NC.

Medicare IM, HINN, DND Notifications

Medicare ABN, MOON Notifications

Denise Wilson, MS, RN, RRT

SENIOR VICE PRESIDENT, DENIAL RESEARCH GROUP/APPEALMASTERS

Denise Wilson is a Registered Respiratory Therapist, Registered Nurse, and has a Master’s degree in Information Systems from the University of Illinois, Springfield. Ms. Wilson has over 30 years' experience in healthcare, including clinical management, education, compliance, and appeal writing. She has extensive experience as an appeals expert and has managed thousands of appeal cases and presented hundreds of cases at the Administrative Law Judge level. As a nationally known speaker and educator on denial and appeals processes, payer behaviors, and standards of care, she has educated thousands of healthcare professionals around the country in successfully overturning medical care denials. Ms. Wilson is a member of the American College of Physician Advisors Advisory Board.

Commercial Appeals

Denise Goodman

Attending Physician, Division of Critical Care Medicine, Ann & Robert H. Lurie Children’s Hospital of Chicago

Professor, Northwestern University Feinberg School of Medicine

Medical Director, Case Management and Care Coordination (Physician Advisor), Ann & Robert H. Lurie Children’s Hospital of Chicago

Dr. Denise Goodman attended medical school at State University of New York at Buffalo, completed a pediatrics residency at Cincinnati Children’s Hospital Medical School, and then a pediatric critical care medicine fellowship at Pittsburgh Children’s Hospital.  Her first faculty position was at the University of Minnesota before moving to Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children’s Hospital of Chicago (formerly Children’s Memorial Hospital).She is a Professor of Pediatrics, has been a practicing pediatric intensivist for over 25 years, and is medical director of a large invasive home ventilation program. She has enjoyed the classic academic life of clinical care, teaching, and research and has also served on the pediatric critical care medicine Subboard of the American Board of Pediatrics and is an Associate Editor at the Journal of Pediatrics. As Medical Director of Case Management and Care Coordination at Lurie Children’s she is responsible for denials management, utilization management, and physician education on a number of topics. In addition, she has led or participated in numerous special projects at the intersection of clinical care and the revenue cycle, including readmission reduction, prior authorization, out-of-network processes, and length of stay management. Awards include selection to “Best Doctors in America” and election as a Fellow of the American College of Critical Care Medicine. Dr. Goodman is the Chair of the American College of Physician Advisors Pediatric Physician Advisor Committee.

Pediatric Physician Advisors

Erica Remer, MD, FACEP, CCDS

PRESIDENT, ERICA REMER, MD, INC.

Dr. Erica Remer practiced as an emergency physician for 25 years and has extensive coding, CDI, and ICD-10 expertise. She was a Physician Advisor of a large multi-hospital system for four years before transitioning to independent consulting in July 2016. Her passion is educating CDI specialists, coders, and healthcare providers with engaging, case-based presentations on documentation, CDI, ICD-10, and denials management. She has written numerous articles and serves as the co-host of Talk Ten Tuesdays, a weekly national podcast. Dr. Remer is on the Association of Clinical Documentation Integrity Specialists (ACDIS) Advisory Board, the Board of Directors for the American College of Physician Advisors (ACPA), and she is Co-Chair for the ACPA Clinical Documentation Integrity Committee.

Sepsis


 

For questions & more information, please contact us at cgorniak@wmrhq.com.

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