Menu
Menu
Non-compliant claims for observation services could end up costing your facility millions. Are you getting observation right?
$259.00 – $359.00
Observation is commonly used but seldom understood. It’s a confusing concept and represents a potential landmine that, when tripped by submitting non-compliant claims, could wreak financial havoc on hospitals. As one health system recently learned when they paid a $4.3 million settlement to the Office of Inspector General (OIG), getting it right is critically important.
And yet, observation remains very complicated. Various payers have varying definitions and time durations for observation services. Coders often misinterpret the intent of the physician. Moreover, patients receiving observation services also receive other services simultaneously, complicating the claim preparation. And there’s a difference between observation services when used for medical and surgical patients. There’s a lot going when observation is used, exponentially increasing the billing complexities.
So, to protect your facility from audits and possible takebacks you and your team need to be totally conversant with the reporting and billing of observation services. That’s why you need to join Dr. Ronald Hirsch for an upcoming webcast where he will provide a detailed review of observation, including its use for Medicare, Medicare Advantage, and commercial payers, utilizing examples of compliantly prepared claims that accurately report observation services so that you know how to get it right. You need to be educated on the subjection of observation from someone who can break it down and make it easy to understand, and you will be when you register to gain access to “Observation Services: Learn to Report and Bill Compliantly,” led by Dr. Ronald Hirsch.
Recently, a health system, in a settlement agreement with the government, paid the Office of the Inspector General (OIG) $4.3 million. The same action would befall your organization.
Utilization review, case management, revenue integrity, revenue cycle, billing, coding, physician advisors.
Ronald Hirsch, MD, is vice president of the Regulations and Education Group at R1 Physician Advisory Services. Dr. Hirsch’s career in medicine includes many clinical leadership roles at healthcare organizations ranging from acute-care hospitals and home health agencies to long-term care facilities and group medical practices. In addition to serving as a medical director of case management and medical necessity reviewer throughout his career, Dr. Hirsch has delivered numerous peer lectures on case management best practices and is a published author on the topic. He is a member of the Advisory Board of the American College of Physician Advisors, a member of the American Case Management Association, and a Fellow of the American College of Physicians. Dr. Hirsch is a member of the RACmonitor editorial board and is regular panelist on Monitor Mondays.
The opinions expressed are those of the author and do not necessarily reflect the views, policies, or opinions of R1 RCM, Inc. or R1 Physician Advisory Services (R1 PAS).
