Note from the speaker: CAR-T education and networking at the Revenue Integrity Symposium

Wednesday, August 22, 2018

By Jugna Shah, MPH

The National Association of Healthcare Revenue Integrity’s (NAHRI) 2018 Revenue Integrity Symposium is just around the corner, and there’s lots in store for those who are attending. The Revenue Integrity Symposium and its accompanying pre- and post-conference events will be held October 16–17 at the Wigwam Resort in Litchfield Park (Phoenix), Arizona.

In addition to the great speaker line-up, I’m most looking forward to the networking opportunities. Talking to attendees about the daily operational challenges they face  implementing CMS’ initiatives/rules that impact coding, billing, the charge description master (CDM), finance, compliance, and the entire revenue cycle is incredibly valuable. It helps me put into context the real-world challenges you face that I’m always striving to get CMS to understand. By attending the conference, my hope is that every attendee will hear something of value such as a best practice from a fellow attendee or something new from a presenter that can be taken home and immediately acted upon to make your daily lives easier.

Join me as I present the following sessions at the Revenue Integrity Symposium:

  • Day one, Tuesday, October 16, at 9:15 a.m.: CMS’ Proposed Changes for CY 2019 OPPS
    • CMS’ payment systems continue to evolve, and the OPPS/APC system is no exception. What’s in store for CY 2019? Take a front-row seat for an analysis of the latest OPPS proposals and news. Session highlights will include the 340B drug program, site-neutral payment policies, the future of C-APCs, changes to drug pricing, and much more. Join us as we decode what CMS’ rules will mean for your outpatient services next year.
  • Day one, Tuesday, October 16, at 3:30 p.m.: Injections and Infusions: Test Your Knowledge and Get Answers
    • This session will help participants challenge their coding, billing, and documentation knowledge related to facility reporting of drug administration (injection/infusion) services, including hydration, therapeutic, and chemotherapy injections. We will also cover documentation best practices, address financial implications of series billing, as well as review some of the most frequently asked questions over the last year. This will be an interactive session, with attendees responding to quiz questions and clinical scenarios.
  • Day two, Wednesday, October 17, at 8 a.m.: Next Generation Technologies: Practical Guidance for Success (with co-speaker John Settlemyer, MBA, MHA, CPC)
    • Providers struggle with how to report and price new, innovative, and sometimes very expensive therapies for drugs, devices, and procedural services.  An example is the latest breakthrough therapy we’ve all been hearing about over the past year called chimeric antigen receptor T-cell (CAR-T) therapy. It’s the perfect storm with coding, billing, pricing/charging, CDM, and reimbursement issues. This session will walk providers through these issues and Medicare's rules/citations on appropriate charging practices. We will use this information to illustrate how differential charging practices fundamentally impacts the ability or inability for a provider to generate an appropriate outlier and/or new technology add-on payment (NTAP).

The session I’m most looking forward to presenting is “Next Generation Technologies: Practical Guidance for Success” because I really want to help demystify what appears to be misinformation, miscommunication, and perhaps just an overall lack of understanding about how CMS’ formulas for outliers and NTAP work. I also want to help clarify how what providers report today impacts payment rates two years down the road. This session is so important for those providing and/or thinking about providing CAR-T—but even those who are not providing CAR-T will gain critical knowledge. The information and principles discussed in this session will apply to all newer, high-cost items and services. Knowing the guts of CMS’ outlier and new tech formulas is critical for revenue integrity so informed decisions can be made about what dollar charge to create. 

The Revenue Integrity Symposium is NAHRI’s premier event for revenue integrity and revenue cycle networking and education so remember to register early and get the early bird $100 discount which ends August 17th, which for NAHRI members comes on top of the $100 they will already save!

This event is the place where critical revenue integrity and revenue cycle best practices and operational information are shared. I look forward to seeing you there!

Editor’s note: Jugna Shah, MPH, is the president and founder of Nimitt Consulting, Inc., a firm specializing in case-mix payment system design, development, and implementation. She has over 20 years of experience working with providers on the ongoing clinical, operational, financial, and compliance implications of Medicare payment systems. Shah is a advocate who has successfully impacted CMS’ rules and regulations over the years and is also an educator who has worked with numerous hospitals on their OPPS issues, as well as drug administration coding, billing, and compliance issues. Shah is a NAHRI Advisory Board member.

For additional information, listen to a recording of our Revenue Integrity Symposium Demo and view the corresponding slides. Revenue integrity professionals wishing to earn support from program administrators to attend the 2018 Revenue Integrity Symposium may adapt our justification letter proposal.

Found in Categories: 
Billing and Claims, Revenue Integrity