Skip to main content
HomeConference Agenda

Agenda (subject to change)

April 30, 2018


 7:30 - 8:30 AM  Registration
 
 8:30 - 8:40 AM  Opening Remarks 
 Lisa Banker, MD
 Vice President, Chief Physician Advisor,
 McLeod Health System
 
 8:40 - 9:00 AM  Burning Platforms for ACPA    Edward Hu, MD, CHCQM-PHYADV
 System Exec Director, Physician Advisor Services
 UNC Health Care System
 9:00 - 10:00 AM  Fire Starters for the Physician Advisor
  • Basic skill sets
  • Medicare A, B, inpatient, observation
  • 2 Midnight Rule, CC44, HINNs
   Pooja Nagpal, MD, CHCQM-PHYADV 
 Physician Advisor, St. Joseph Health
 10:00 - 10:45 AM  Proprietary Screening Tools - A "Meeting" of the Minds
 on Status Decisions
 


 William Rifkin, MD
 Managing Editor, MCG
 Hearst Healthcare Network





 Steve Silverstein, MD
 Vice President, Chief Clinical Architect
 Change Healthcare (InterQual)
 10:45 - 11:00 AM  BREAK    
 11:00 - 11:45 AM  Interdisciplinary Rounds - Keeping Feet to the Fire                 
  • How rounds are structured
  • Who participates
  • Benefits realized
   Howie Stein, DO, CHCQM-PHYADV
 Physician Advisor, CentraState Medical Center
 11:45 - 12:30 PM  Case Management in the ED - Up Front Ignition
  • The case for ED case management
  • Operations and obstacles
   Day Egusquiza
 President, AR Systems, Inc
 12:30 - 1:00 PM  WORKING LUNCH     
 1:00 - 1:50 PM  Documentation Integrity Fuels Everything
  • Importance of documentation
  • How to get physician engagement
  • Understanding the relationship with coding
   Trey LaCharite', MD, FACP, SFHM, CCS, CCDS
 Medical Director, CDI and Coding
 University of Tennessee
 1:50 - 2:40 PM  Observation - The Art of Churn and Burn
  • How observation medicine is different
  • How an observation unit should operate
  • What do you measure?
   Juliet B. Ugarte Hopkins, MD, CHCQM-PHYADV
 Physician Advisor, ProHealth Care
 2:40 - 3:00 PM  BREAK     
 3:00 - 3:50 PM  Quality - A Many Splendored Thing                                         Nick Ulmer, MD, CPC
 Vice President, Clinical Services
 Spartanburg Regional Medical Center
 3:50 - 4:40 PM  Burning Questions Panel    Pooja Nagpal, Juliet B. Ugarte Hopkins, Howie Stein
 4:40 - 5:00 PM  Closing Comments
 Day One Evaluations 
   


May 1, 2018


 7:15 - 8:00 AM  BEST PRACTICE BREAKFAST SESSIONS
 
 8:00 - 8:10 AM  Opening Remarks 
 Lisa Banker, MD
 Vice President, Chief Physician Advisor
 McLeod Health System
 8:10 - 9:00 AM  We Like it Hot - Let's Add Some PEPPER
  • Understand purpose and structure of PEPPER report
  • How to act on the report
   Ronald Hirsch, MD, CHCQM-PHYADV
 Vice President, R1 Physician Advisor Services
 9:00 - 9:50 AM  CDI Conundrum Diagnoses
  • Frequent and problematic diagnoses
  • How precise documentation can defend against denials
   Tim Brundage, MD, CCDS
 President, Brundage Medical Group
 9:50 - 10:10 AM  BREAK    
 10:10 - 11:10 AM  UM Committees Keep the Fires Burning
  • Structure of the UM Committee
  • Operationalizing the UM Committee
  • Reducing costly clinical variation
 
 Bart Caponi, MD
 Medical Director, UR & Case Management
 University of Wisconsin




 Edward Hu, MD, CHCQM-PHYADV
 System Exec Director, Physician Advisor Services
 UNC Health Care System
 11:10 - 12:00 PM  Peer to Peer and Medicare Advantage Plans
  • Differences between MA plans and Medicare FFS
  • Strategies for MA plan denials
  • Improving relationships with MA medical directors
   Brian Moore, MD, FACEP, CHCQM-PHYADV
 Medical Director, Utilization Management and
 Physician Advisor Services
 Carolinas HealthCare System
 12:00 - 12:30 PM  WORKING LUNCH
   
 12:30 - 1:15 PM  Mission Creep:
The Physician Advisor and Payer Contracts
  • Understand the importance of contracts
  • How a physician advisor can be helpful
  • Understand how HCCs can be useful in negotiation             

 
 Jessica Gustafson, Esq.
 Health Law Partners

 


 Elizabeth Lamkin, MHA
 President, PACE Healthcare
 1:15 - 2:00 PM  Denials Scene
  • RAC focuses, present and future
  • Current state of the ALJs
 
 Jessica Gustafson, Esq.
 Health Law Partners




 Abby Pendleton, Esq.
 Health Law Partners
 2:00 - 2:45 PM  Sparking an Overturn - Tips on Fighting Denials
  • Practical advice on strategic approaches
  • Pitfalls to avoid
   Lisa Banker, MD, FACP, CCS, CCDS
 Vice President, Chief Physician Advisor
 McLeod Health System
 2:45 - 3:00 PM  BREAK     
 3:00 - 4:00 PM  Finance 101 for the Physician Advisor  
 Sandy Wolskill, FHFMA
 Director, Healthcare Finance Policy, Revenue
        Cycle



 Chuck Alsdurf, CPA
 Director, Healthcare Finance Policy, Operational
        Initiatives
 4:00 - 4:45 PM  Burning Questions Panel    Brian Moore, Elizabeth Lamkin, Sandy Wolskill         
 4:45 - 5:00 PM  Closing Comments
 Day Two Evaluations
   


May 2, 2018


 7:15 - 8:00 AM  BEST PRACTICE BREAKFAST SESSIONS
 
 8:00 - 8:10 AM  Opening Remarks 
 Lisa Banker, MD, FACP, CCS, CCDS
 Vice President, Chief Physician Advisor
 McLeod Health System
               
 8:10 - 9:00 AM  The Two Midnight Rule and Short Stay Reviews
  • How physician documentation can be improved
  • New developments in CMS directed short stay reviews
  • Case examples and interpretation
   Ferdinand Richards III, MD                                        
 KEPRO, Chief Medical Officer
 9:00 - 9:50 AM  Seeing Through the Smoke - What's Coming?
  • Overview of future plans for the auditors
  • How a physician advisor can help to ease the denial burden
   Ronald Hirsch, MD, CHCQM-PHYADV
 Vice President, R1 Physician Advisor Services
 9:50 - 10:10 AM  BREAK    
 10:00 - 12:00 PM  Faculty Case Discussion Panel    Edward Hu, MD, CHCQM-PHYADV
 Ronald Hirsch, MD, CHCQM-PHYADV
 Brian Moore, MD, FACEP, CHCQM-PHYADV
 Juliet B. Ugarte Hopkins, MD, CHCQM-PHYADV
 12:00 - 12:10 PM  Closing Comments
 Final Evaluations