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Discovering Additional Net Revenue – Lessons from a Root-cause Investigator

To ensure financial stability in today’s healthcare environment, revenue cycle professionals must shift resources from the industry-standard approach of claim correction – claims scrubbers, works cues and billing edits – to preventive processes that eliminate the need for corrective action. Learn the industry-tested charge capture best practices that allow organizations to progress from a reactive to a proactive approach through the development and adoption of sustainable, key business processes. And through case study examples, see how hospitals have applied these best practices to engage and elevate the emphasis of revenue integrity throughout the organization.

This on-demand webinar covers:

  • The different options for moving from a reactive to proactive charge capture process
  • Identifying revenue cycle best practices that would best fit your hospital in improving its revenue integrity efforts
  • Applying key strategies on how to engage clinical and other departments to willingly support new business processes

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In 2018, CMS reduced payment for some outpatient drugs used in OPPS settings, cutting reimbursement at many 340B participating hospitals by nearly 30%. Some organizations are excluded from the payment cut, but all hospitals participating in the 340B program will have new requirements to report an additional modifier on drugs acquired under the 340B program.

In this educational webinar, Bonnie Kirschenbaum and Craneware’s Kathy Schwartz will provide a detailed overview of the 2018 OPPS changes, steps hospital pharmacy, revenue cycle, and revenue integrity teams can take to ensure compliance with the new requirements, and recommendations on improving pharmacy revenue integrity at your organization to help offset this unprecedented payment cut.

After watching this educational webinar, attendees will have an understanding of

  • The payment cuts and which hospitals and drugs will be affected
  • New “JG” and “TB” modifiers and other requirements
  • Steps hospital teams can take to ensure compliance
  • Steps hospital teams can take to improve pharmacy charge capture and revenue integrity
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In 2018, CMS reduced payment for some outpatient drugs used in OPPS settings, cutting reimbursement at many 340B participating hospitals by nearly 30%. Some organizations are excluded from the payment cut, but all hospitals participating in the 340B program will have new requirements to report an additional modifier on drugs acquired under the 340B program.

In this educational webinar, Bonnie Kirschenbaum and Craneware’s Kathy Schwartz will provide a detailed overview of the 2018 OPPS changes, steps hospital pharmacy, revenue cycle, and revenue integrity teams can take to ensure compliance with the new requirements, and recommendations on improving pharmacy revenue integrity at your organization to help offset this unprecedented payment cut.

After watching this educational webinar, attendees will have an understanding of

  • The payment cuts and which hospitals and drugs will be affected
  • New “JG” and “TB” modifiers and other requirements
  • Steps hospital teams can take to ensure compliance
  • Steps hospital teams can take to improve pharmacy charge capture and revenue integrity
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How can pharmacy and financial teams improve pharmacy reimbursement by fixing common data gaps between the purchase history, the pharmacy formulary and the chargemaster?

This webinar will cover:

  • Pharmacy revenue cycle and revenue integrity challenges and how the one health system addressed them
  • Pharmacy Cost-to-charge analytics
  • The health system’s approach to correcting missing and incorrect multipliers, invalid HCPCS and other common revenue cycle issues
  • Pharmacy revenue integrity best practices in Cerner Pharmnet
[/et_pb_text][/et_pb_column][/et_pb_row][et_pb_row][et_pb_column type="4_4"][et_pb_button _builder_version="3.2.2" button_alignment="center" custom_button="on" button_text_color="#ffffff" button_bg_color="#0066cc" button_border_width="0" button_border_radius="10" button_use_icon="off" button_text_color_hover="#ffffff" button_bg_color_hover="#66cc00" button_border_radius_hover="10" button_text="Download Pharmacy ChargeLink Fact Sheet" button_url="http://host.craneware.com/af2?LinkID=CH00096645eR00000038AD" url_new_window="on" /][/et_pb_column][/et_pb_row][/et_pb_section][et_pb_section bb_built="1" _builder_version="3.0.89" custom_padding="0px|||" prev_background_color="#000000" next_background_color="#e6eaee" global_module="25686"][et_pb_row global_parent="25686" module_class="social-share-blog" _builder_version="3.0.90" background_size="initial" background_position="top_left" background_repeat="repeat" module_alignment="center"][et_pb_column type="4_4"][et_pb_divider global_parent="25686" color="#d7d7d7" height="5px" _builder_version="3.2" max_width="80%" module_alignment="center" custom_padding="||40px|" /][et_pb_text global_parent="25686" _builder_version="3.0.106" module_alignment="center"]

Share the Love!

[/et_pb_text][et_pb_image global_parent="25686" src="https://craneware.wpengine.com/wp-content/uploads/2018/03/twitter-share.png" url="https://twitter.com/home?status=" align="center" module_class="share-icon twitter" _builder_version="3.2.2" /][et_pb_image global_parent="25686" src="https://craneware.wpengine.com/wp-content/uploads/2018/06/linkedin_share.png" url="https://www.linkedin.com/shareArticle?mini=true&url=" align="center" module_class="share-icon linkedin" _builder_version="3.2.2" /][/et_pb_column][/et_pb_row][/et_pb_section][et_pb_section bb_built="1" fullwidth="off" specialty="off" _builder_version="3.0.106" background_color="#e6eaee" prev_background_color="#ffffff" next_background_color="#2d79c2" global_module="26920"][et_pb_row global_parent="26920" background_position="top_left" background_repeat="repeat" background_size="initial"][et_pb_column type="4_4"][et_pb_text global_parent="26920" _builder_version="3.0.90" background_layout="light"]

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[/et_pb_button][/et_pb_column][et_pb_column type="1_2"][et_pb_button admin_label="Desktop Phone" global_parent="20823" button_text="1-877-624-2792" background_layout="dark" module_class="footer-cta-btn desktop-phone" _builder_version="3.2.2" custom_button="on" button_text_size="17" button_text_color="#ffffff" button_bg_color="#66bf48" button_border_color="#66bf48" button_border_radius="5" button_use_icon="off" disabled="off" disabled_on="on|on|" button_bg_color_hover="#66bf48" button_border_color_hover="#66bf48" button_url="#"]

 

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[/et_pb_button][/et_pb_column][/et_pb_row][/et_pb_section] [post_title] => Connecting Pharmacy Cost Management and Reimbursement in Cerner PharmNet [post_excerpt] => [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => connecting-pharmacy-cost-management-and-reimbursement-in-cerner-pharmnet [to_ping] => [pinged] => [post_modified] => 2018-06-22 10:52:42 [post_modified_gmt] => 2018-06-22 10:52:42 [post_content_filtered] => [post_parent] => 0 [guid] => https://public.craneware.com/?p=29364 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) ) [post_count] => 1 [current_post] => -1 [in_the_loop] => [post] => WP_Post Object ( [ID] => 29364 [post_author] => 2 [post_date] => 2017-10-04 20:36:23 [post_date_gmt] => 2017-10-04 20:36:23 [post_content] => [et_pb_section bb_built="1" next_background_color="#000000" _builder_version="3.2.2"][et_pb_row _builder_version="3.2.2"][et_pb_column type="4_4"][et_pb_video _builder_version="3.2.2" src="https://craneware.wpengine.com/wp-content/uploads/2018/05/2017-10-Connecting-Pharmacy-Cost-Management-and-Reimbursement.mp4" image_src="https://craneware.wpengine.com/wp-content/uploads/2018/06/pharmacy-cost-and-reimbursement-cerner-pharmnet-webinar.jpg" play_icon_color="#0c71c3" max_width="65%" module_alignment="center" border_width_all="2px" box_shadow_style="preset3" border_color_all="#ecf0f1" /][/et_pb_column][/et_pb_row][et_pb_row _builder_version="3.0.106" use_custom_width="on" custom_width_px="750px" module_class="webinar-body-text"][et_pb_column type="4_4"][et_pb_text _builder_version="3.2.2"]

How can pharmacy and financial teams improve pharmacy reimbursement by fixing common data gaps between the purchase history, the pharmacy formulary and the chargemaster?

This webinar will cover:

  • Pharmacy revenue cycle and revenue integrity challenges and how the one health system addressed them
  • Pharmacy Cost-to-charge analytics
  • The health system’s approach to correcting missing and incorrect multipliers, invalid HCPCS and other common revenue cycle issues
  • Pharmacy revenue integrity best practices in Cerner Pharmnet
[/et_pb_text][/et_pb_column][/et_pb_row][et_pb_row][et_pb_column type="4_4"][et_pb_button _builder_version="3.2.2" button_alignment="center" custom_button="on" button_text_color="#ffffff" button_bg_color="#0066cc" button_border_width="0" button_border_radius="10" button_use_icon="off" button_text_color_hover="#ffffff" button_bg_color_hover="#66cc00" button_border_radius_hover="10" button_text="Download Pharmacy ChargeLink Fact Sheet" button_url="http://host.craneware.com/af2?LinkID=CH00096645eR00000038AD" url_new_window="on" /][/et_pb_column][/et_pb_row][/et_pb_section][et_pb_section bb_built="1" _builder_version="3.0.89" custom_padding="0px|||" prev_background_color="#000000" next_background_color="#e6eaee" global_module="25686"][et_pb_row global_parent="25686" module_class="social-share-blog" _builder_version="3.0.90" background_size="initial" background_position="top_left" background_repeat="repeat" module_alignment="center"][et_pb_column type="4_4"][et_pb_divider global_parent="25686" color="#d7d7d7" height="5px" _builder_version="3.2" max_width="80%" module_alignment="center" custom_padding="||40px|" /][et_pb_text global_parent="25686" _builder_version="3.0.106" module_alignment="center"]

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Develop a better understanding of how to manage the ever-changing payor requirements for outpatient Medical Necessity and Prior Authorization. Revenue Cycle expert Becky Kinsella will discuss the importance of communication and physician education in the development of Medical Necessity and Prior Authorization protocols, and share medical necessity best practices.

This webcast is being produced with the IL AAHAM and HFMA of Greater St. Louis, but registration is open to all. After this webinar you will be able to:

Recommended for:

Healthcare provider participants from the financial, clinical, and operational areas who want to understand better how to utilize the CDM in achieving best outcomes.

  • Identify opportunities to reduce outpatient Medical Necessity and Prior Authorization denials
  • Better understand the importance of utilizing Medical Necessity tools to ensure revenue integrity
  • Learn how to develop and implement a best practice approach to Medical Necessity
  • Understand the importance of accurate diagnosis coding and documentation
  • Develop an understanding of the differences between Medical Necessity, Prior Authorization and Clinical Criteria requirements
  • Learn how these requirements interact with Compliance
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[/et_pb_button][/et_pb_column][/et_pb_row][/et_pb_section] [post_title] => Preventing Medical Necessity and Prior Authorization Denials [post_excerpt] => [post_status] => publish [comment_status] => open [ping_status] => open [post_password] => [post_name] => preventing-medical-necessity-and-prior-authorization-denials [to_ping] => [pinged] => [post_modified] => 2018-06-22 10:55:29 [post_modified_gmt] => 2018-06-22 10:55:29 [post_content_filtered] => [post_parent] => 0 [guid] => https://public.craneware.com/?p=29352 [menu_order] => 0 [post_type] => post [post_mime_type] => [comment_count] => 0 [filter] => raw ) ) [post_count] => 1 [current_post] => -1 [in_the_loop] => [post] => WP_Post Object ( [ID] => 29352 [post_author] => 2 [post_date] => 2017-09-21 20:10:32 [post_date_gmt] => 2017-09-21 20:10:32 [post_content] => [et_pb_section bb_built="1" next_background_color="#000000" _builder_version="3.2.2"][et_pb_row _builder_version="3.2.2"][et_pb_column type="4_4"][et_pb_video _builder_version="3.2.2" src="https://craneware.wpengine.com/wp-content/uploads/2018/05/2017-09-Preventing-Medical-Necessity-and-Prior-Authorization-Denials.mp4" image_src="https://craneware.wpengine.com/wp-content/uploads/2018/06/medical-necessity-denials-webinar.jpg" play_icon_color="#0c71c3" max_width="65%" module_alignment="center" border_width_all="2px" box_shadow_style="preset3" border_color_all="#ecf0f1" /][/et_pb_column][/et_pb_row][et_pb_row _builder_version="3.0.106" use_custom_width="on" custom_width_px="750px" module_class="webinar-body-text"][et_pb_column type="4_4"][et_pb_text _builder_version="3.2.2"]

Develop a better understanding of how to manage the ever-changing payor requirements for outpatient Medical Necessity and Prior Authorization. Revenue Cycle expert Becky Kinsella will discuss the importance of communication and physician education in the development of Medical Necessity and Prior Authorization protocols, and share medical necessity best practices.

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Recommended for:

Healthcare provider participants from the financial, clinical, and operational areas who want to understand better how to utilize the CDM in achieving best outcomes.

  • Identify opportunities to reduce outpatient Medical Necessity and Prior Authorization denials
  • Better understand the importance of utilizing Medical Necessity tools to ensure revenue integrity
  • Learn how to develop and implement a best practice approach to Medical Necessity
  • Understand the importance of accurate diagnosis coding and documentation
  • Develop an understanding of the differences between Medical Necessity, Prior Authorization and Clinical Criteria requirements
  • Learn how these requirements interact with Compliance
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