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Feb. 7, 2017

Noon-1:30 p.m. Central

Is managed care heartburn keeping you up at night? This webinar will touch on a wide array of issues Medicare Advantage Organization’s experience, including defining an inpatient versus an outpatient under the Medicare Part C definition as opposed to the traditional Medicare definition; confusion on patient status and patient status disputes; and insight into the ever-changing world of MA organization audits and denials/disputes.

Learning Objectives:

  • Describe the challenges with the Medicare management plans;
  • Describe contracting issues that are adding complexity to the clarification of patient status; and
  • Provide ideas for moving forward with the new world of audit and denials/disputes.

Target Audience:

  • Chief Executive Officers;
  • Chief Managed Care Officers and managed care staff;
  • Chief Physician Executives;
  • Chief Financial Officer;
  • Revenue cycle staff;
  • Physician Advisors;
  • Compliance Officers and staff; and
  • Health Information officers.

Faculty:

Day Egusquiza, president, AR Systems Inc., brings over 30 years experience in health care reimbursement, hospital business office operations, contracting and compliance implementation.  Additionally, her experience includes eight years as a director of a physician medical management billing service which included completing an integrated business office between a hospital and a large multi-specialty physician clinic.  She has been an entrepreneur in hospital and physician practice accounts receivable management and a leader in redesigning numerous organizations.  Her work includes providing guidance as a compliance and reimbursement educator while providing operational insight on the revenue cycle impacts of Medicare Recovery Audit Contractors.  Additionally, she has been instrumental in researching and preparing national education on the impact of the Prescription Drug Benefit.

Egusquiza is a nationally recognized speaker on continuous quality improvement, bench-marking, redesigning, reimbursement systems and implementing an operational focus of compliance- both in hospitals and practices.  She has been on the AAHAM National Advisory Council, HFMA National Advisory Council, is a past President of the Idaho HFMA Chapter and recently received the Lifetime Achievement Award.