2012 Emergency Medicine Summit
May 1-2, The Williamsburg Lodge, Williamsburg, VA
The AgendaMay 1, Tuesday
8:00a / Registration & Refreshments
9:00a / Sink or Swim: The Future of US Healthcare (Granovsky)
A macro description regarding healthcare evolution and how groups should strategize and position themselves for success. Are you onboard, getting thrown overboardor tied to the anchor? Things you should be watching out for as healthcare evolves.
10:00a / Major Risk Management Issues in Emergency Medicine(Fargis, Adams)
- What are the top ‘gotcha’s’ and average indemnity payouts? What impact does the Virginia cap have on your rates? If national reform passes, what then?
- And then there’s EMTALA; Virginia complaints have sharply increased over the past 10 years. We’ll present the top complaints and how to avoid them.
- What has been achieved by other states in the pursuit of state legislation for EMTALA-specific liability protection? What obstacles will need to be overcome to enact in Virginia?
11:00a / Break
11:15a / Optimizing ED Revenue (Granovsky)
The top 5 things a practice can do to ensure optimized revenue: scribes, MLPs, benchmarks for documentation and coding, procedure charge capture, reconciliation, management level reporting.
12:15p / Lunch
12:45p / Lunch Speakers
National Healthcare Reform: EM’s Challenge
Preserving Access to Emergency Services Under Healthcare Reform. As states’ budget crises fuel cutbacks in emergency services, this fragile healthcare safety net is likely to burst into flames. What CMS and healthcare reform initiatives will put out the fire? CMS Chief Medical Officer Dr. Stephen Cha will outline current strategies and plans to save ‘the net’.(Cha)
ACEP’s 360oView and Inside the Beltway. Update on the latest developments around the country impacting ACEP's advocacy on behalf of emergency medicine, our members and patients. Learn how ACEP and chapters are responding to the challenges.(O’Connor)
2:00p / Expectations of Millennium Physicians (Katz)
We know there are generational differences, and the one we belong to is radically different from the “Millennials.” The label refers to those born after 1980 –the first generation to come of age in the new millennium. Do you really think you know what graduating residents are looking for in a job?
3:30p / Adjourn
Time for golf, or a walk around Colonial Williamsburg, then join us for the Reception!
May 2, Wednesday
7:30a / Registration & Refreshments
8:00a / Payer Audits – What is happening and how do you prepare? (Stimler)
You need to understand the different types of governmental audits.We’ll discuss how you can focus on what to expect and how to prepare effectively.
9:00a / Effective Recruiting (Katz)
Do you have what they want, or are you feeling their expectations ‘unreasonable’? Learn how to attract and sign the best candidates for your group.
10:30a / Break
10:45a / Improving Efficiency in the ED (O’Connor)
With hospitals looking for ways to both improve the functionality and quality of their organization, we need to proactively address efficiency challenges and work with hospital leaders to prioritize and systematically reduce weaknesses. Here is a look at the UVA experience with EMR’s, scribes, and boarding policies for example, with a few good pearls and, of course, pitfalls to avoid.
12:15p / Lunch with Panel Discussion
Opportunities Beyond the ER (Thomson, Sutherland, Clare)
Eyeing retirement? Need a sabbatical? Looking for a totally new job? Discover what others are doing and ways you can uncover a meaningful change of pace, whether full or part time.
1:45p / Adjourn
May 2, Wednesday
2012 Documentation & Coding Updates
7:30a / Registration and Refreshments8:00a / Payer Audits – What is happening and how do you prepare? (Stimler)
You need to understand the different types of governmental audits.We’ll discuss how you can focus on what to expect and how to prepare effectively.
9:00a / Beyond the history and exam, what chart documentation helps code choice? (Stimler)
- Components of MDM
- Medical necessity
- Severity of the case
10:00a / Break
10:15a / Finding procedures in the chart and what documentation is needed to code and bill (Stimler)
Being able to find procedures buried within a chart can be difficult even for the seasoned coder. Review what to look out for on any chart for the majority of procedures, and discuss procedures performed in the emergency department. Review what documentation is necessary to code and subsequently bill for each of these procedures.
12:00noon / Lunch
1:30p / Case review for code choice (Stimler)
There are many types of presenting problems with a variety of ancillary study workups and therapeutic interventions per case. Multiple case studies will be presented that will provide a focused look per chart at the ancillary study workups, therapeutic interventions and final dispositions that help the coder obtain a better understanding of not only the severity of the case but also if the case is one with an immediate threat to life or physiologic (bodily) function.
4:00p / Adjourn
ABOUT THE SPEAKERS
Invited Speakers:
Marilyn Tavenner - is currently the Acting Administrator for the Centers for Medicare & Medicaid Services. Previously, Ms. Tavenner was Principal Deputy Administrator for the Centers for Medicare & Medicaid Services (CMS). As the Principal Deputy Administrator, Ms. Tavenner served as the agency’s second-ranking official overseeing policy development and implementation as well as management and operations.
Confirmed Speakers:
Rodney K. Adams, Esq.is a health care trial attorney at LeClairRyan. He has been advising and defending health care providers for over twenty years. Mr. Adams has a unique niche in patient care issues and has published two books on various aspects of the topic, Virginia Medical Law (now in its second edition) and Clinical Trials and Human Research: A Practical Guide to Compliance (coauthored with F. Rozovsky). Mr. Adams also contributed to Rozovsky & Woods, The Handbook of Patient Safety Compliance: A Practical Guide for Health Care Organizations. His guidance,whether during a strategic discussion or during a crisis, is based on practical experience before juries and government boards.
Mr. Adams represented several large hospitals and medical colleges in Chicagobefore moving to Richmond in 1991. He currently counsels and defends hospitals,nursing homes, physicians, and other health care providers in court and administrativeforums throughout the Commonwealth. Virginia Business Magazine lists Mr. Adams inthe “Legal Elite” among Virginia lawyers, and Virginia Lawyers Weekly has repeatedlyrecognized his work in its annual “Largest Defense Verdicts.” Mr. Adams is certified bythe National Board of Trial Advocacy in Civil Trial Practice1 and is included in The BestLawyers in America.
Stephen Cha, MDis Chief Medical Officer at the Center for Medicaid and CHIP.
Steve Fargis is Vice President of Professional Risk Associates, an independent insurance agency offering medical professional liability insurance in the mid-Atlantic region. Steve began his career in health care administration with the Bon Secours Health System and later served as VP of the Virginia Hospital Association. He is a graduate of the Medical College of Virginia with a Masters in Health Administration. In working with the Virginia Hospital Association he transitioned to The Virginia Insurance Reciprocal as VP for Underwriting and Marketing. In 1995 he joined National Capital Reciprocal Insurance Company (NCRIC) and helped lead NCRIC from a privately held $15M physician insurance reciprocal to an $80M publicly-traded carrier. Steve served as the Chief Operating Officer for NCRIC Group until its merger with ProAssurance in 2005. Steve currently serves as Vice President for Professional Risk Associates (PRA), an agency solely dedicated to providing physician clients with solutions in professional liability insurance. PRA is the largest specialty agency in medical malpractice in the mid-Atlantic region serving over 4,500 healthcare clients.
Michael Granovsky, MD, FACEP, CPC is a board-certified emergency physician and certified professional coder. Dr. Granovsky is the Director of the American College of Emergency Physicians’ (ACEP) Coding and Reimbursement course, and leads the education efforts of ACEP’s National Coding and Nomenclature Advisory Committee. Dr. Granovsky also serves as editor for both ED Coding Alert and the American Academy of Professional Coders’ (AAPC) ED Specialty Coding Certification Exam. A nationally recognized expert in Emergency Medicine coding and reimbursement, Dr. Granovsky is a regularly featured speaker at multiple state ACEP Coding and Reimbursement Conferences, ACEP’s Scientific Assembly and the ED Director’s Course.
As LogixHealth’s President of Coding, Dr. Granovsky continually monitors the changing ED coding environment, directly interfacing with both government and private payers to optimize coding while achieving maximum compliance.
Barbara Katz brings 25 years of professional recruitment and training experience to her position and has been working exclusively with Emergency Medicine physicians since 1991. Well known for her informative, and often provocative monthly column “The Katz Report” (originally known as “Effective Job Searching”) running in Emergency Physicians’ Monthly for over 8 years, Barb has become a recognized expert in the Emergency Medicine marketplace.
Robert O’Connor, MD, MPH, FACEPis a member of the ACEP Board of Directors. He is professor and chair, and physician-in-chief of the Department of Emergency Medicine at the University of Virginia Health System in Charlottesville, Va. He is also an emergency physician at the Culpeper Regional Hospital in Culpeper, Va. He has held a variety of leadership positions within the American Heart Association since 2001.
Over the course of his ACEP membership, Dr. O’Connor has served as councilor or alternate for two state chapters and one section, and has served on the council steering committee, candidate forum subcommittee, several reference committees and the tellers, credentials and elections Committee. He is a reviewer for Annals of Emergency Medicine and has served as an editor for Foresight, Critical Decisions in Emergency Medicine and the ACEP/AHA textbook, Emergency Cardiovascular Care and CPR. Dr. O’Connor has also served on the scientific review committee as a reviewer for Emergency Medicine Foundation grant applications, the EMS committee and the injury and trauma committee.
Dr. O’Connor, a graduate of Haverford College, earned his medical degree from the Medical College of Pennsylvania. He completed his residency in emergency medicine at the Medical Center of Delaware. He received his master’s degree in public health at the Medical College of Wisconsin.
MAY 2 Panelists
F. Brian Clare, MDis currently Vice President of Revenue Cycle Management for TSystem in Dallas, Texas. He cofounded and managed several private ER physician groups and is the founder of Practice Management Associates, Inc, a revenue cycle management company recently acquired by TSystem. He started one of the first Scribe programs on the east coast in 1998, and now through eScribe Management Services, manages several programs in the US. He is Chief Medical Officer for IVWatch,Inc., a startup company with new technology that detects early IV infiltrations. He is on the board of directors for TowneBank and Trinity School of Medicine.
Sara F. Sutherland, MD, isan Emergency Medicine Specialist at the University of Virginia Health System, Department of Emergency Medicine, Charlottesville.
Chris M. Thomson MD, MS, FACEPisChairman and Medical Director, Department of Emergency Medicine, Centra Emergency Services, Lynchburg. Dr. Thomson is also a consultant with several hospitals in China and was a physician for the Beijing Olympics for NBC News.
May 2 Coding and Reimbursement Track
John Stimler, DO, CPC, CHC, FACEPis a founder and managing member of BSA Healthcare. For the past 20 years, he has been actively involved in reimbursement issues at the local and national levels, including physician-charting education, proper choice of billing codes, fee schedule creation, billing operations and managed care negotiations.
Dr. Stimler is a graduate of the College of Osteopathic Medicine and Surgery in Des Moines, Iowa. He completed his residency in emergency medicine at University Medical Center in Jacksonville, Florida.
Dr. Stimler then served as the acting director of the emergency medicine residency program at University Medical Center before founding Emergency Physicians Incorporated (EPI), an emergency medicine group that grew to contract with 12 hospital emergency departments. As executive vice president of EPI, Dr. Stimler managed all reimbursement activities and helped negotiate most hospital coverage and managed care contracts for the group. He was also president of EPI Clinics, an entity that operated, and subsequently sold, two freestanding urgent care centers.
From 1992 to 1999, Dr. Stimler served as medical director for Gottlieb's Financial Services, a medical billing and coding company that billed for more than 300 emergency departments in 33 states. As medical director, he focused on resolving regulatory issues involving Medicaid, Medicare, workers' compensation and managed care.
In the political arena, Dr. Stimler was active in legislative issues involving managed care payment to providers and Medicaid fee schedules. He was also involved in coder medical education and chart audits for proper code choice and documentation review. He continues to educate physician groups and billing and coding organizations about proper chart documentation and code choice methodology.
Dr. Stimler is an attending clinical instructor at the Shand's Jacksonville emergency medicine residency program. He is a former president of the Florida College of Emergency Physicians (FCEP), and a former chairman of the FCEP Medical Economics Committee. Additionally, Dr. Stimler is a former member of the American College of Emergency Physicians (ACEP) Governmental Affairs Committee. He is currently a member of the ACEP Reimbursement Committee.
He was also recently chosen as a Hero of Emergency Medicine by the American College of Emergency Physicians