Healthcare Coding, Billing and Reimbursement: An Overview

MentorHealth
Date: Thursday September 12, 2019
Time:

10:00 AM PDT | 01:00 PM EDT

Duration: 90 Minutes
Instructor: Michael Stearns
Webinar Id: 801789
23 Days Left To Register

 Live 

$139.
One Attendee
$299.
Unlimited Attendees

Recorded

$179.
One Attendee
$379.
Unlimited Attendees ?

Combo

Live + Recorded
$269 $318  
One Attendee
Live + Recorded
$599 $678  
Unlimited Attendees ?

By attending this webinar you will learn about how physicians, hospitals, and other healthcare providers bill for their services and how payors use that information to adjudicate the claim, You will also learn about the major healthcare coding systems and how coding data are used for analysis and reporting.

Overview:

Many people work with various aspects of healthcare coding and billing but may not understand how providers generate their claim data, how they report the data to payors, and how payors use that information to reimburse providers.

This webinar provides a high-level overview of all major aspects of healthcare coding, billing, and reimbursement.

We discuss key data elements of the two major claim forms (CMS-1500 and UB04) and how that information tells the story of the patient’s encounter with the provider. We review the major coding systems including CPT, HCPCS, ICD-9, ICD-10, DRG, and APC, and examine how codes in each system are assigned and the purpose of each system. We review the typical process flow for how a provider submits a claim and gets reimbursed. We discuss the fundamentals of physician and hospital reimbursement, including a brief conversation of relative value units (RVUs) are and how they are used to reimburse providers. We discuss commonly used methods to reimburse hospitals, including per diems, per stay, DRGs, and APCs. Finally, we review common pitfalls that analysts encounter when working with healthcare claims data sets and how to be on the watch for them.

Why should you Attend: This webinar is ideal for persons who work with healthcare claims data and who want to better understand the fundamental elements of billing, coding, and reimbursement. You will learn about how physicians, hospitals, and other healthcare providers bill for their services and how payors use that information to adjudicate the claim. You will also learn about the major healthcare coding systems and how coding data are used for analysis and reporting.

Areas Covered in the Session:

  • Key data elements on healthcare claim forms (CMS-1500 and UB04)
  • Explanation of the major coding systems including CPT, HCPCS, ICD-9, ICD-10, DRG, and APC
  • Discussion of how providers compile charges and assign codes
  • Brief process flow for submitting claims and getting reimbursed from payors
  • Explanation of RVUs and how they are used
  • Discussion of common reimbursement methods for physicians, hospitals, and surgery centers
  • Common pitfalls incurred when working with healthcare data and how to be on the watch for them

Who Will Benefit:
  • Healthcare Data and Claims Analysts
  • Healthcare Researchers
  • Billers and Coders
  • Providers

Speaker Profile
Michael Stearns, MD, CPC, CFPC, is a physician informaticist, certified professional coder (CPC), certified family practice coder (CFPC). He is the CEO and Founder of Apollo HIT, LLC, an Austin-based company that provides consulting services in the areas of healthcare information technology and compliance. His company assists organizations with meeting their documentation, coding, EHR optimization and program goals, including their performance in the Merit-based Incentive Payment System and Alternative Payment Models.

During his career Dr. Stearns has received several awards for teaching and contributions to patient safety and patient privacy initiatives. He played a central role in the design and development of vocabularies at the National Institutes of Health (NIH) and provided a leadership to the development of the Systematized Nomenclature of Medicine - Clinical Terms (SNOMED CT). He has served in a leadership capacity for two leading EHR vendors and as an advisor to several emerging HIT organizations.

He is a cofounder and lecturer at the University of Texas at Austin Health Information Technology Certificate Program, a nationally recognized model for HIT workforce development. He has been invited to testify in Washington, D.C. before federally sponsored HIT policy and standards organizations on five separate occasions. He served as the founding board president of the Texas eHealth Alliance, an organization that provides stakeholder input related to health information technology policy matters to state legislators. He is also an accomplished author and lecturer on a range of health care quality, health information technology, coding/compliance and quality-based performance initiatives.


You Recently Viewed