This program will provide a foundation of knowledge and understanding of the DRG system used as the structure for reimbursement under the Medicare and Medicaid programs. Included in this will be a review of the DRG relative weights, case mix index and expected lengths of stay. Medical record coding will be explained in the context of how hospitals get reimbursed. This will be followed by a discussion of managed care and managed care contracting as well as the various managed care products currently on the market.
Also, included will be a discussion on bundled payments and what case management professionals need to know to assist their organizations in controlling cost and length of stay in a bundled payment environment where patients may access care and use resources at any touch point on the continuum.
A review of the state of the art in case management from both the acute care and community sides will also be discussed as well as the emerging trends that correlate directly with changes in health care reimbursement over time.
The Centers for Medicare and Medicaid Services (CMS) provides us with two Conditions of Participation that apply to the work of case management professionals. These include the Conditions of Participation for Discharge Planning and the Conditions of Participation for Utilization Review. This webinar will focus on these rules as they apply to the role of utilization review. In order for case management departments to be compliant with these regulations, RN and social work case managers must understand these ‘rules of the road’ for utilization review and work within their boundaries.
In this jam-packed program you will learn how to stream-line your utilization management process as well as understand the Conditions of Participation for Utilization Review and how they impact on your work as a case manager. We will discuss the differences between utilization review and utilization management. The process for incorporating medical necessity into the process of utilization management will be explained. This will be followed by a discussion of the compliance components for utilization review including the utilization management plan, the utilization management committee, Condition Code 44, and the two-midnight rule. How to incorporate the two-midnight rule into your utilization management process. Also explained will be the various types of clinical reviews performed by the case manager.
The various types of Hospital-Issued Notices of Non-Coverage (HINNs) will be described with examples of how they are used. You will learn whether or not your utilization management committee is effective and compliant.
Venue: Recorded Webinar
Imagine the thrill of automating those repetitive Excel tasks that have been draining your productivity. Picture the convenience of effortlessly streamlining complex processes, leaving you with more time to focus on what truly matters. Now, consider the positive impact you can have on your team and clients by offering streamlined, error-free solutions. Excel macros are powerful tools that can transform your Excel experience by automating repetitive tasks, freeing up your time for more important work. If you often find yourself performing the same actions or dealing with time-consuming Excel processes that beg for automation, it's time to dive into the world of macros. In this session, we will explore two methods for creating macros in Excel: The Macro Recorder and The Macro Editor, ensuring you have a comprehensive understanding of both. Objectives By the end of this session, you will have gained proficiency in creating and editing macros using Excel's Macro Recorder and the Macro Editing Tool. Why You Should Attend Mastering macro creation and editing is a crucial skill for advanced Excel users. This knowledge will not only save you valuable time but also benefit your colleagues and clients, as you'll be able to automate various Excel-based tasks and processes. If you've never created macros before, this webinar is for you. Topics covered Best practices for planning your macros Creating macros using the Macro Recorder Saving files as macro-enabled Excel workbooks Executing macros effortlessly Adding a macro-triggering button A comprehensive tour of the Macro Editor Making basic modifications to macros (VBA fundamentals) Leveraging the Personal Macro Workbook to share macros across all your files Who Should Attend? This webinar is designed to kickstart your journey into the world of macros. It's suitable for intermediate-to-advanced Excel users across all industries and job roles. Although we will be using the latest version of Excel for Windows, the majority of the functionalities discussed are applicable to earlier versions of the application as well.
Does your organization consider the strategic, operational, and compliance related impact of human capital decisions on its ability to achieve its business goals and objectives? Does your human capital help your organization achieve its management goals? Are your employment policies and practices creating material risks and liabilities? Are AI issues now affecting your employment practices? This webinar discusses the development and use of HR Audits in answering these questions and in addressing critical risk management and due diligence issues. The threats and risks from human resource management issues are increasing. No longer measured in only fines, penalties, and awards for non-compliance, human resource management affects keys business metrics, including the organization’s valuation and credit rating. Further, improper human resource management can significantly reduce managerial prerogatives and seriously damage the organization’s reputation and employment brand. As a result, HR audits have become an important tool in identifying problem areas and are increasingly evolving from an ad hoc audit activity to a critical element of an organization’s risk management and compliance processes. Numerous external forces and factors have an impact on the demand for and scope of HR audits. First, in the global economy, human capital has become for many organizations the single most important determinant of competitiveness, productivity, sustainability, and profitability. Increasingly, the organization’s human capital is the source of innovation and a driver of business success. Second, a confluence of economic, political, and social factors, including corporate scandals, the failure of organizations to adequately assess risks, and the increasing number of stockholder initiatives, have resulted in increased statutory and regulatory requirements, a call for greater transparency, and increased internal and external audit activity. Third, governmental agencies have become more active — some would argue more aggressive — and have committed more resources to conducting assessments of employment policies and practices. Importantly, the EEOC, the OFCCP, U.S. DOL, and ICE have advised employers that they consider self-assessments and audits a “best practice.” Fourth, AI is no longer used solely as a tool to support HR activities. AI is quickly becoming a critical element of strategic and tactical management activities. It this environment, identifying and assessing human capital related risks have become a critical element of an organization’s success. As a result, an organization’s ability to audit and manage these risks plays an increasing role in helping it succeed. Why You Should Attend HR audits can assist your organization identify the weaknesses and failures of its human resource management and employment practices compliance activities. HR Audits can further help your organization identity critical issues effecting the management of your human capital asset and provide an indication of your organization’s commitment to identifying and ferreting out unlawful practices and processes. Thus, your use of HR audits should consider strategic and tactical issues, identify risks, assess compliance, and develop both quantitative and qualitative methods and measurements to assess those risks. Your HR audit activities should help you assess your organization’s performance and should provide you with data that will allow you to evaluate human capital outcomes. Areas Covered in this Session A discussion of current trends in HR Auditing A discussion of senior management’s HR auditing goals and issues An understanding of the critical components of an HR audit A discussion of economic, political, regulatory, and social factors affecting HR audits A review the use of HR auditing tools A discussion of the development of the HR Audit Scorecard Who will Benefit HR audits and assessments play an increasingly important role in managing an organization. Like other management tools, HR audits help organizations access, manage, and monitor the successes and failures of their use of key resources and help them plan for future requirements. As a result, attendees will gain an understanding of the required elements of improving their organization’s performance. HR professionals Internal and external auditors Business owners Compliance managers Risk managers CEOs CFOs Topic Background HR audits HR auditing HR risk assessments HR compliance
Critical Access Hospitals (CAHs) must comply with the Centers for Medicare & Medicaid Services’ Conditions of Participation located in Appendix W in the manual. This eight-part webinar series will cover the CAH CoP manual. There were changes and new regulations for CAHs in 2020, including a change to all the tag numbers, some which do not include Interpretive Guidelines or Survey Procedures. Changes include infection prevention and control and antibiotic stewardship, QAPI and Swing Bed changes. This seminar will help CAHs comply with specific CoP problem areas, such as nursing care plans, necessary policies and procedures, medication administration and drug storage, and informed consent to name a few. Part Two of Eight: Emergency Services, Staffing and Responsibilities, Provision of Services, Emergency Procedures and EMTALA Objectives Describe staffing requirements and supervision Recall the required14 emergency department written policies that must be present Describe that CMS has a list of emergency drugs and equipment every CAH must have Recall that a CAH must comply with EMTALA requirements Emergency Services 14 Emergency department policies ED staffing Equipment, Supplies, and Medication Blood and Blood Products Staffing/Personnel Coordination with Emergency Response Systems Staffing and Responsibilities Staffing and responsibilities Physician supervision Transfer of patient Patient admissions Provision of Services Patient care policies Scope of services Emergency medical services Medical management Diagnostic and therapeutic services Supplies Outpatient services Outpatient director Inpatient services Census and Ensuring compliance EMTALA Physician lists Central log Medical Screening examination Admit or transfer Appendix and Resources
In today’s fast-paced and data-driven world, efficiency, accuracy, and innovation are more critical than ever. This 60-minute session will introduce you to the seamless integration of ChatGPT with Excel, showing how AI can dramatically boost your spreadsheet capabilities. Learn how to speed up data analysis, automate tedious tasks, and uncover deeper insights—all with the help of AI. Whether you’re building complex formulas or running data analysis, integrating ChatGPT into your workflow allows you to bypass manual processes, generate powerful insights faster, and make smarter business decisions. This course is designed to meet the needs of both seasoned Excel pros and beginners looking to enhance their skills with the power of artificial intelligence. Why You Should Attend This session is a must-attend for anyone looking to optimize their use of Excel by incorporating cutting-edge AI technology. Whether you're a data analyst, business professional, or anyone who regularly works with spreadsheets, this training will equip you with practical skills to enhance your efficiency and make more informed decisions. Don't miss out on the opportunity to stay ahead of the curve and learn how to harness the power of ChatGPT to simplify complex tasks and boost your productivity. Topics Covered Introduction to ChatGPT and its integration with Excel Automating repetitive tasks in Excel with AI Generating complex formulas and functions using ChatGPT Enhancing data analysis and visualization with AI-driven insights Best practices for maximizing the synergy between Excel and ChatGPT Real-world applications and case studies Who should attend This training is ideal for Excel users of all levels, including data analysts, financial professionals, business managers, and anyone interested in leveraging AI to improve their productivity in Excel. Whether you're looking to automate tedious tasks or gain deeper insights from your data, this session will provide you with the knowledge and tools to elevate your Excel skills with ChatGPT.