How Your Hospital is Reimbursed: A Primer for Hospital Case Managers
Instructor:
Bev Cunningham
Product ID: 706132
Training Level: Basic to Intermediate
- Duration: 60 Min
Why Should You Attend:
In past years reimbursement was not an issue for case management staff. The Payment was based on volume and medical necessity that seemed more clearly understood. As healthcare reform has evolved, healthcare costs have escalated and the strategy of payers to ensure reimbursement only for quality, case management departments must understand the reimbursement process for the hospital and the post-acute care environment. More and more patients make decisions for healthcare providers based on their financial responsibility. This is true with nearly every benefit plan that a patient might have. To guide a patient in decision-making for care, the case management staff member must be able to discuss costs for the patient—whether they have Medicare, Medicare Advantage, Medicaid, managed Medicaid, or a commercial payment source. Even the unfunded patient has choices to make.
Areas Covered in the Webinar:
- Healthcare industry today and mandate for change
- Prospective payment
- Length of stay: What is expected and how it is impacted
- How we are reimbursed
- Healthcare reform
- Managed care
- Value-based reimbursement
- Bundled payments
- Purpose of case management in relation to reimbursement
- Strategies for the RN case manager, social work case manager and case management leader
- Understanding reimbursement, its relationship to case management and case management’s relationship to it
- Collaboration with patients, families and caregivers in relationship to reimbursement
Who Will Benefit:
- RN case managers
- Case management leaders
- Social workers
- Physician advisors
- Executives with oversight for case management
Bev Cunningham
Consultant, Case Management Concepts LLC
Bev Cunningham, MS, RN, ACM is a founding partner of Case Management Concepts, LLC. She has a 25-year deep working knowledge of case management with specific expertise in denials management, patient flow and the role of the Case Manager and Social Worker in the Case Management process. Bev is also a certified case manager with the American Case Management Association. She has served as a Commissioner on the Commission for Case Management Certification and is a fellow with the Advisory Board. Bev is also the former Vice President of Resource Management at Medical City Dallas Hospital.
She has co-authored a book for hospital case managers—Core Skills for Hospital Case Managers and has written the utilization management chapter in the past two editions of CMSA’s book, Core Curriculum for Case management.
More Training By Experts
- Engaging Hospitalists in the Case Management Process
- The Case Management Leader's Role in Auditing for Compliance: How to Know What You Don't Know?
- Bundled Payments and the Case Management Department in Hospitals
- Case Management Leadership (Part 1)
- Engaging Hospitalists in the Case Management Process
Refund Policy
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Registrants may cancel up to two working days prior to the course start date and will receive a letter of credit to be used towards a future course up to one year from date of issuance. ComplianceOnline would process/provide refund if the Live Webinar has been cancelled. The attendee could choose between the recorded version of the webinar or refund for any cancelled webinar. Refunds will not be given to participants who do not show up for the webinar. On-Demand Recordings can be requested in exchange. Webinar may be cancelled due to lack of enrolment or unavoidable factors. Registrants will be notified 24hours in advance if a cancellation occurs. Substitutions can happen any time. On-Demand Recording purchases will not be refunded as it is available for immediate streaming. However if you are not able to view the webinar or you have any concern about the content of the webinar please contact us at below email or by call mentioning your feedback for resolution of the matter. We respect feedback/opinions of our customers which enables us to improve our products and services. To contact us please email [email protected] call +1-888-717-2436 (Toll Free).
