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Physician Advisor Clinical Documentation Improvement & Integrity Institute

The Physician Advisor Clinical Documentation Improvement & Integrity (PAC-CDI®) Institute was developed specifically for physicians serving the hospital through teaching, consulting, and advising both the case management/utilization review department and the hospital on matters regarding physician practice patterns, over and under-utilization of resources, medical necessity, levels of care, care progression, denial management, compliance with governmental and private payer rules and regulations, and working in collaboration with payers and the community. The Physician Advisor is a key member of the organization’s leadership team charged with meeting goals of cost and quality of care. 

Overall Program Learning Objectives:

Define Medicare Conditions of Participation and the Utilization Review (UR) Committee Physician Advisor (PA) and the UR Committee involvement
Chair, co-chair, educator or facilitator
Understand the changing state of today’s healthcare system, as related to the important trends toward required compliance activities to prevent future claims denials.
Identify the diverse educational needs for healthcare personnel regarding the significant changes in the healthcare reimbursement field and how these impact the denials that an organization will confront.
Identify important methods of (and how to manage) administrative & provider organizational acceptance and “buy-in” to improve the denial management and appeals processes.
Describe the goals, key benefits, and strategies of having an on-site based denial management and appeals program.
Identify effective techniques to communicate with both clinicians (physicians, mid levels, nurses, care managers) and non-clinical (coding & billing) staff in order to appeal current denials and prevent future denials.
Apply techniques to develop and implement a structured Denial Management and Appeals Improvement Program within acute care hospitals.
Identify compliance methods on auditing, monitoring, and evaluating the effectiveness of your denial management program.

Process Requirements:

Accurate, precise and explicit medical records documentation
Effective case management processes including level of care assignment
Correct and compliant coding that reflects the true severity of illness and complexity of care

Our Approach:

Evidence-based
Incorporating InterQual clinical criteria and regulatory requirements
Concise, focused, rapid- response strategy
Evaluate demand letters and denials for likelihood of successful appeals
Prepare comprehensive responses to RAC, MAC and other auditors designed to maximize the chances of successful reversals as quickly as possible
Identify your denial and recovery audit vulnerabilities and implement corrective action strategies to preempt future assessment risks

The C-DAM® Program recognizes and builds on your past experience, and prepares you for future healthcare challenges in medical necessity and clinical documentation. The C-DAM® Program is for professionals at varying levels of health care including:

Physicians
Hospitalists
Physician Assistants
Nurses
Nurse Practitoners
Clinical Documentation Specialists
Case Managers/Utilization Reviewers
Health Information Managers/Coding Professionals
Quality Assurance Professionals
Compliance Professionals 

Attendees have the option of taking the Certification Exam within 6 weeks of this Program.

Payment/Substitutions/Cancellation

Registration accepted until seminar is full.

Registration Fee: $1,295

Clinical Documentation Specialist Certification Examination: $395
Total: $1690

No refunds will be given for cancellations. A conference credit may be given when requested in writing prior to the seminar for which you are registered. No refunds will be given for no-shows. Registration fees must be paid by posted deadlines. Registration may be transferred to a member of your organization up to 24 hours in advance of the seminar.

For more information about our programs contact:
740-968-0472
kstokes@docucompllc.com