Description:-

The teleconference addresses the interface between the hospital’s chargemaster and the Medicare cost report. Setting charges and the way in which the chargemaster is organized can affect the proper development of the Medicare cost report. Recent instances have arisen in which the cost-to-charge ratios (CCRs) have negatively impacted hospital reimbursement under Medicare programs such as APCs and DRGs.The Medicare program has been making changes to the cost reporting process in areas such as implantable devices.Chargemaster personnel need to work closely with cost reporting personnel to make certain that there is full compliance in a highly technical financial area.

Objectives of the session:

• To Review How APCs and DRGS Use The Charges From Filed Claims
• To Appreciate How The Cost Report Is Prepared
• To Review Recent Changes in the Cost Reporting Process
• To Understand The All-Important Cost-to-Charge Ratios (CCRs)
• To Review Revenue Codes and Impacts on CCRs
• To Appreciate Issues Surrounding Implantable Medical Devices
• To Recognize How Chargemaster Pricing Structure Can Influence the Cost Report
• To Appreciate The Medicare Charging Rule and Its Impact on Both The Chargemaster and Cost Reporting Process
• To Review Action Steps that Chargemaster Coordinators Can Take To Improve The Cost Reporting Interface to the Chargemaster
• To Review Special Situations In Which Reimbursement for Hospitals Is Directly Influenced by the Cost Report
• To Address Special Situations Such As Provider-Based Clinics and Special Medicare Payment Processes

Agenda of the session:

1. Overview
   1. Cost Reporting Process
   2. Developing Chargemaster Pricing and Charges
   3. APC Background
   4. DRG Background
   5. Recent Federal Registers for APCs and DRGs
   6. Revenue Codes
2. APC and DRG Use of Charge Data
   1. Conversion of Charges to Costs Using CCRs
   2. Recalibration
   3. Rebasing
   4. Special Payment Issues
3. Review of Medicare Charging Rule
   1. Charging Limitation
   2. Consistency of Charges
4. Cost Report Preparation
   1. Review New Form and Changes
   2. Basic Financial Process
   3. Overview of Various Financial Schedules
   4. Cost-to-Charge Ratios (CCRs)
   5. ‘Grossing-Up’ Charges
5. Chargemaster and Cost Reporting Interface
   1. Establishing a Liaison With Cost Reporting Personnel
   2. Routine Communication Lines
6. Special Situations
   1. Blood and Blood Products
   2. Device Dependent APCs and DRGs
   3. Implantable Medical Devices
   4. Changes to the Cost Reporting Process
   5. Current CMS Proposed Changes Affecting CCRs
   6. Provider-Based Clinics

       7.Chargemaster Coordinator Action Steps

Who should attend?

• Chargemaster Coordinators
• Billing and Claims Generation Personnel
• Compliance Personnel
• Patient Financial Management Personnel
• Cost Accounting Personnel
• Cost Report Personnel
• Financial Analysts
• Managed Care Contract Personnel
• Revenue Enhancement Personnel
• Chief Financial Officers
• Chief Compliance Officers
• Financial Planners
• All Other Hospital Personnel Interested in Pricing