What special coding and billing requirements are required for provider-based clinics? What are the requirements under the provider-based rule (PBR)? What do hospitals have to do to establish provider-based clinics? To answer these questions and more please come join us in this upcoming Webinar.

Webinar Objectives

• Review the Provider-Based Rule (PBR)

• Understand the differences between freestanding and provider-based clinics

• Understand the economic advantages of provider-based clinics

• Appreciate special requirements for provider-based clinics

• Appreciate special compliance concerns associated with provider-based status

• Understand the steps needed to create and/or convert to a provider-based clinic

• Discuss coding and billing issues for provider-based clinics

• Delineate how the chargemaster should be established to support coding and billing for both technical and professional components

• Discuss operation issues such as setting fees, patient relations and medical staff organizational structuring

• Work through several case studies involving the establishment of the provider-based clinics 

The following are a few of the topics to be discussed

• Review of the Provider-Based Rule (PBR)

  • Development of the PBR

  • 42 CFR §413.65

  • Review of Definitions

  • Rules and Regulations

  • Recognition by Non-Medicare Third-Party Payers

• Economic Advantages of Provider-Based Status

  • Clinics

  • Clinical Services

  • Costs for Provider-Based Status

  • Recognizing Provider-Based Clinical Services

• Establishing Provider-Based Clinics

  • Meeting the PBR Requirements

  • Special Areas of Concern

    • Medical Records Integration

    • Off-Campus vs. On-Campus

    • Physicians and Practitioners

    • EMTALA Compliance

    • Fire Safety Concerns

    • Hospital Conditions of Participation

    • Human Resource Issues

  • Physician Supervision Requirements

• Coding and Billing

  • Technical Component E/M Coding

  • Surgical Services Coding

  • Medical Services Coding

  • Setting Up The Chargemaster

    • Establishing Charge Structures

    • Use of Modifiers

• Special Types of Provider-Based Clinics

  • Wound Care Clinics

  • Specialty Clinics

  • Pain Management Clinics

  • Medication Management Clinics

• Sources for Further Information 

Target Audience

Chargemaster personnel, compliance personnel, claims transaction personnel, financial analysts, operating officers, clinic administrators and managers, and all personnel involved with provider-based clinics and/or clinical operations including nursing staff and interested physicians/practitioners.