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Case Management Assignment Protocol (CMAP): An Answer to the Problem of Claims Denials for Unnecessary Admissions
Webinar
August 13, 2009
Time: 12 - 1 p.m. CENTRAL TIME
Register for this event online:
August 13, 2009 ($295 per line)
Program Description
In 2003, Florida Medical Quality Assurance, Inc. (FMQAI) conducted a pilot project for the purpose of developing methods to decrease unnecessary admissions in Florida Hospitals. FMQAI's supposition was that unnecessary admissions were due to lack of documentation by physicians to support the medical necessity of admissions and also physician lack of knowledge and understanding of hospital admission criteria. To address these concerns, FMQAI developed the Case Management Protocol.
The Protocol was designed to increase the number of hospitalized patients who were assigned to the correct inpatient vs. observation (outpatient) status; to decrease unnecessary admissions; and to decrease the payment error rate. The CMAP protocol focuses particularly on short-stay admissions for symptom codes rather than diagnosis codes and admissions through the emergency department. This session will review the CMAP process and use of the screening tools; discuss procedures for resolving differences between attending physician and case manager; and, identify features of CMAP which may raise issues under state law and Medicare payment policy.
Who Should Participate
CEOs, COOs, CFOs, CMOs, CNOs, all coding, billing and reimbursement staff, financial analysts, compliance officers, legal counsel
Faculty
Mark Guza, Arnall, Golden, Gregory LLP,br>
Mark Guza joined Arnall, Golden, Gregory LLP from the Office of General Counsel of the Department of Health and Human Services, where he developed extensive experience in a wide variety of regulatory compliance matters involving health care providers. Guza's practice with the federal government included litigation of Medicare and Medicaid reimbursement disputes, civil money penalties, termination of Medicare provider agreements health planning and certificate of need issues, as well as Inspector General exclusions. During his last several years with the Office of General Counsel, he supervised a team of nine attorneys responsible for enforcement litigation of health care provider regulatory matters. Guza graduated cum laude from the University Of Georgia School Of Law in 1974
The views expressed by the speaker do not necessarily reflect the policies or opinions or the Wisconsin Hospital Association.
Registration Information
Fee
$295.00 for one phone line per site
Please register only one name per connection.
Additional phone lines will be billed at $295.00 each.
How the Webinar Will Work
Dial-in instructions, on-line login instructions and any other reference materials will be emailed to each registrant approximately three days prior to the conference. If you do not receive them by this date, please email llittel@wha.org.
It is the responsibility of the registrant to access presentation materials prior to the day of the event. If your e-mail address changes, you do not receive an e-mail with instructions from WHA, or if you are unable to open presentation materials, please contact Lisa Geishirt at WHA two days prior to the event to allow time to address the issue.
Substitution, Transfer and Cancellation Policy
Cancellations received in writing up to five business days prior to an event will be given a full refund less a $50 processing fee. No refunds will be given for cancellations received less than five business days prior and day-of-program no-shows. Substitutions are accepted.
Register for this event online:
August 13, 2009 ($295 per line)
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