Description:-

• Are there special coding and billing requirements for the ED?
• How should ED documentation be developed?
• Why is EMTALA such a difficult area?
• What are hospitals really required to do under EMTALA?
• What really constitutes hospital property?
• What is a prudent layperson?
• What about non-emergency presentations to the ED?
• How do ER services interface to observation services?
• What constitutes an ED?
• Are there freestanding EDs?
• Why are transfers from one hospital ED to another hospital such a sensitive issue?
• Do ambulance services have anything to do with EMTALA?

Teleconference/Webinar Objectives:-

• To Understand Why Coding, Billing and Reimbursement Is Different for the ED?
• To Appreciate Special Documentation Requirements for the ED
• To review the need for developing a special ED compliance plan.
• To discuss the current and evolving requirements for EMTALA compliance.
• To review the definitions and conditions for EMTALA and how these concepts apply to coding and billing.
• To compare and contrast EMTALA with the Conditions for Participation (CoPs).
• To understand the special coding and billing requirements for the ED relative to EMTALA.
• To appreciate the provider-based clinic interface to EMTALA.
• To address special issues such as freestanding EDs.
• To review different approaches to audits and reviews of the ED relative to coding, billing and EMTALA.

Teleconference/Webinar Outline/Agenda:-

1. Overview of ED Compliance

·         EMTALA Compliance

·         Coding, Billing and Reimbursement Compliance

·         Special ED Considerations

·         ED Documentation

·         Observation and Associated Services

·         Special Payment Processes

2. EMTALA Basics

·         Definitions

·         On-Going EMTALA Rule Changes

3.  EMTALA Compliance

·         EMTALA Survey Process

·         EMTALA Compliance Problem Areas

4. Evolution in EMTALA Rules & Regulations

·         Special Services Hospital Transfers

·         Community Call Programs

·         Qualified Medical Persons

·         State Operations Manual - Interpretive Guidelines

5. Coding, Billing and Reimbursement for the ED

·         Special Coding and Billing Requirements for the ED

·         Coding and Billing Policy and Procedure Development

·         Non-Physician Providers (NPPs) in the ED

·         Joint Services Between Physicians and NPPs

·         EMTALA Interface to Coding/Billing

6. Special ED Situations

·         Provider-Based Clinics – EMTALA Requirements

·         Hospital Clinics Deemed as Dedicated EDs

·         Written Compliance Plan Relative to EMTALA

·         Freestanding EDs

7. Audit and Review Approaches

8. References for Further Information

Prerequisites for Participating:-

General knowledge of the Emergency Department operations.

Suggested Attendees:-

ED Directors and Managers, ED Personnel, ER Physicians, ER Nurses, Coding Personnel, Billing and Claims Transaction Personnel, Chargemaster Coordinators, Financial Analysts, Compliance Personnel, and Other Interested Personnel