OVERVIEW

Provider-Based Rule - Update for 2019 is organized by Skillacquire and will be held on Feb 28, 2019.

Suggested Attendees:
• Clinic Managers
• Clinic Administrators
• Coding Personnel
• Billing and Claims Transaction Personnel
• Nursing Staff
• Clinical Service Area Personnel
• Chargemaster Coordinators
• Financial Analysts
• Compliance Personnel
• Physicians
• Non-Physician Practitioners
• Healthcare Auditors
• Other Interested Personnel

Description:
Hospitals are ever increasingly establishing provider-based clinics of all types. The Provider-Based Rule (PBR) is complex and there are definite ambiguities. While hospitals can enjoy increased revenues from provider-based clinics, compliance with all the rules and regulations is challenging.

Session Objectives:
• To briefly review the Provider-Based Rule (PBR).
• To review the criteria that must be achieved for clinics to be recognized as provider-based.
• To update the current status of changes in payment to off-campus provider-based clinics as provided through Section 603 of the BBA 2015.
• To review the further changes made by the 21st Century Cures Act.
• To briefly update critical physician supervisory rule changes.
• To discuss documentation requirements relative to physician supervision requirements.
• To appreciate the increase in reimbursement for provider-based clinics.
• To understand the attestation and request for determination processes.
• To understand the need for updating and the documentation of organizational structuring relative to the PBR.
• To understand the review/audit process for assessing current and/or potential provider-based situations.
• To understand the economic benefits versus the compliance requirements.
• To appreciate the relationship of PBR relative to the Conditions for Payment, Conditions of Participation and gaining billing privileges.
• To understand the regulatory pressures for reducing reimbursement for provider-based clinics.
• To appreciate the evolving guidance that is being provided by CMS and/or the Regional Offices.
• To work through several case studies.

Additional details will be posted as soon as they are available.