Live Audio Conference on APCs: What to Expect for 2015 By Duane Abbey: Understand the difference between composite and comprehensive APCs.

1. © 1999-2014 Abbey & Abbey, Consultants, Inc. Slide # 1
APCs: What to Expect for 2015
What about all of the other payment mechanisms such as cost outliers
and copayment amounts?
Presenter - Duane Abbey
Follow us :

2. © 1999-2014 Abbey & Abbey, Consultants, Inc. Slide # 2
Presentation Faculty
Duane C. Abbey, Ph.D., CFP – Dr. Abbey is a healthcare consultant and educator with over 20
years of experience. He has worked with hospitals, clinics,
physicians in various specialties, home health agencies and other health care providers.
His primary work is with optimizing reimbursement under various Prospective Payment
Systems. He also works extensively with various compliance issues and performs
chargemaster reviews along with coding and billing audits.
Dr. Abbey is the President of Abbey & Abbey, Consultants, Inc. A wide range of consulting
services is provided across the country including charge master reviews, APC compliance
reviews, in-service training, physician training, and coding and billing reviews.
Dr. Abbey is the author of fourteen books on health care, including:
•“Non-Physician Providers: Guide to Coding, Billing, and Reimbursement”
•“Emergency Department: Coding, Billing and Reimbursement”, and
•“Chargemasters: Strategies to Ensure Accurate Reimbursement and Compliance”.
Recent books include: “Compliance for Coding, Billing & Reimbursement A Systematic
Approach to Developing a Comprehensive Program”, “Introduction to Healthcare Payment
Systems”, “Fee Schedule Payment Systems” and “Prospective Payment Systems” from
Taylor and Francis. He has just finished the fourth book in the Healthcare Payment System
Series; “Cost-Based, Charge-Based and Contractual Payment Systems”.

3. © 1999-2014 Abbey & Abbey, Consultants, Inc. Slide # 3
This workshop and other material provided are designed to provide accurate and
authoritative information. The authors, presenters and sponsors have made every
reasonable effort to ensure the accuracy of the information provided in this
workshop material. However, all appropriate sources should be verified for the
correct ICD-9-CM Codes, ICD-10-CM Diagnosis Codes, ICD-10-PCS Procedure
Codes, CPT/HCPCS Codes and Revenue Center Codes. The user is ultimately
responsible for correct coding and billing.
The author and presenters are not liable and make no guarantee or warranty;
either expressed or implied, that the information compiled or presented is error-
free. All users need to verify information with the Fiscal Intermediary, Carriers,
other third party payers, and the various directives and memorandums issued by
CMS, DOJ, OIG and associated state and federal governmental agencies. The
user assumes all risk and liability with the use and/or misuse of this information.
Disclaimer

4. © 1999-2014 Abbey & Abbey, Consultants, Inc. Slide # 4
 To review the many proposed changes to APCs for 2015.
 To recognize the general trends for APCs with particular attention to
increased bundling.
 To understand how recent changes in the cost reporting process affect
APCs payments.
 To understand the complex nature of APCs and associated compliance
issues including RAC concerns.
 To review changes in grouping with particular attention to new CPT and
HCPCS codes.
 To appreciate the potential financial and operational impact of the
proposed changes.
 To understand how important it is for hospitals to comment to the
proposed changes.
 To understand the difference between composite and comprehensive
APCs.
 To review the possible impact of the proposed change on high impact
areas such as observation, the Emergency Department, interventional
radiology and associated areas.
 To review changes to and trends for the Provider-Based Rule (PBR).
 To discuss anticipated future changes and directions for APCs.
OPPS Proposed Update for CY2015
Objectives

5. © 1999-2014 Abbey & Abbey, Consultants, Inc. Slide # 5
To see the complete presentation check the
below link:
http://www.audioeducator.com/hospitals-and-health-systems/apcs-2015-
08-26-14.html

6. © 1999-2014 Abbey & Abbey, Consultants, Inc. Slide # 5
To see the complete presentation check the
below link:
http://www.audioeducator.com/hospitals-and-health-systems/apcs-2015-
08-26-14.html