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Take steps to safeguard a crucial revenue source
It’s disturbing, but true: Many hospitals write off untold millions of dollars in revenue from pharmaceuticals because of coding and billing mistakes — mistakes that could easily be prevented. By popular demand, MedLearn’s drug coding and billing expert, Robin Miller Zweifel, BS, MT (ASCP), will share surefire strategies for protecting this indispensable revenue source for hospitals. She’ll also cover your risks under the Medicare Recovery Audit Contractor (RAC) program and the steps you should be taking to protect your organization. Join us on December 17…and get the how-to knowledge you need to start 2010 on the right foot! Highlights:
- HCPCS codes — how to ensure accurate assignments, starting with the set-up of your chargemaster and continuing through file maintenance and validating the accuracy of NDC dose forms, route of administration and other key data
- Revenue codes — proven tactics and best practices for the correct assignment, supplemented with everyday examples to reinforce learning
- Discarded drugs — a review of recent CMS directives covering the segregated reporting of waste vs. single-use vials, the appropriate use of modifier “JW” and restrictions on billing for discarded drugs
- Claim denials — how to avoid common pitfalls, including lack of medical necessity, incorrect HCPCS code assignments, billing unit errors, incorrect billing of self-administered drugs and lack of prior authorization
- OIG summary — what the Office of the Inspector General uncovered in 2009 and what you might expect in an audit during 2010
- Your RAC risk — making certain that your coding, billing and documentation practices, as well as your use of modifiers, will stand up to a RAC audit
- Answers to frequently asked questions, such as “what determines the correct revenue code assignment for drugs and biologicals?”
Faculty: Robin Miller Zweifel, BS, MT (ASCP)
Robin is author of MedLearn’s Revenue Capture Guide for the Pharmacy book. A senior healthcare consultant who came to MedLearn with a distinguished 16-year career in the clinical setting, Robin’s services to clients include conducting CPT coding and chargemaster assessments; reviews of provider operations for regulatory compliance; and assisting with the implementation of facility compliance programs. Since 2006 she has focused extensively on providing clients with coding tips and tactics for the billing of infusion services and pharmaceuticals. Using MedLearn’s National Drug Code validation process, Robin conducts pharmacy chargemaster analyses to ensure the accuracy of HCPCS and billing units. Her review of provider operations assists hospitals with protecting department revenues by reducing billing risks and improving the accuracy of claims data.
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