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HCC Best Practices for Proactive Medical Management


May 30-31, 2013
Westin Arlington Gateway
Arlington, VA

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Conference Details
Due to customer demand, we are excited to announce that we've moved our annual HCC event to May in Arlington, VA. This conference will build on the success of the previous conferences while providing practical, timely updates to help you continue to evolve your medical management and healthcare finance practices with sound HCC coding.

Are you and your team up to snuff when it comes to improving member care, responding to increasing government mandates, and receiving appropriate CMS reimbursement? What about the exchanges – do you know how to apply risk adjustment to your exchange products? Do you know how ACOs and Meaningful Use will affect coding?

Join us for the most comprehensive HCC Best Practices conference out there!

Core Curriculum:
  • How Meaningful Use and ACOs – the two hottest trends in healthcare – will affect coding
  • The coder's perspective roundtable: RADV, coding teams, approaches, etc.
  • The insurance perspective: Evaluating coded progress notes
  • The auditor's perspective: How you can develop a bullet-proof RADV action plan
  • Best practices for partnering with providers
  • ICD-10 spotlight: Implementation, chase lists, legal/compliance aspects
  • Risk adjustment on the health insurance exchanges
  • HCCs and Star Ratings: Coding and revenue integrity
  • Revenue cycle management in coding
  • Using benchmarks to determine compliance risk
  • Case studies
  • And more!

BONUS: Pre-conference workshop for the coding novice: “HCC Coding 101 Best Practices Workshop.” This valuable workshop requires a separate registration and is worth training credits. Start your conference off on the right foot with this refresher course!

AAPC
*This program has the prior approval of AAPC for 5.5 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

Letter From The Chairman
Dear Colleague,
The new Risk Adjustment model has been introduced to the industry by CMS.

The fireworks that took place when the Advanced Call letter was released in February are now over. The new guidelines and changes to the HCC Model were finalized and released on April 1st. The changes are retroactive to coding and billing that began on January 1st 2013, are you prepared?

Will these changes impact your training of your providers? How will the changes be perceived by those providers who are actively engaged in risk adjustment coding? The time to examine your HCC best practices is now, and the place is our conference event, “HCC Best Practices for Proactive Medical Management.

During this day-and-one-half event attendees will:

  • Learn how the CMS Final Rate Notice and the HCC Model will affect them
  • Gain best practices for system organization and workflow to enhance HCC data and outcomes
  • Gain insight from an auditor’s perspective on developing a bulletproof RADV Action Plan
  • Discuss positive member engagement strategies for their risk adjustment program
  • Discover how using benchmarks helps determine compliance risk

We welcome you to our conference knowing that the experiences and knowledge gained will help you make key decisions on how your organization will move forward in the new HCC Model. The change to the HCC model has already happened and now is the time to take action.

We have free passes to the event available thru April 30th.

Sincerely,
Ryan C Dodson
Director of HCC Operations and Conference Chair

Rave Reviews from the Inaugural Event:
"I felt the information shared during the pre-conference workshop was very helpful. Phenomenal speakers well-versed on Managed Care, HCCs and documentation. I would definitely participate in future conferences."
-- Connie Altman, Physicians Alliance Corp.

"This was my first conference with Opal Events and as both a Speaker and an Attendee, I think it was a great success!"
-- Holly Cassano, ACCUCODE Consulting, LLC.

"I enjoyed the entire conference and was glad that I was able to attend. It is so nice to go to a conference and find the powerpoint is all set up for you and words! Great job! Lots of networking and contacts. Well worth my time."
-- Kathy Arner, Geisinger Health Plan

More Testimonials
Who Will Attend:
This event has been designed specifically for executives from health plans and physicians groups, specifically:

Chief Executive Officers
Chief Compliance Officers
Chief Financial Officers
Chief Medical Officers
Chief Operating Officers
HCC Specialists
HCC Risk Management

Vice Presidents, Directors, Managers and Analysts of:
  • Risk Adjustment
  • Enrollment
  • Revenue Management and Analysis
  • Medical Management
  • Utilization Management
  • Reconciliation
  • Finance
  • Accounting
  • Medicare
  • Quality
  • Compliance
  • Senior Products
  • Government Programs
  • Product Development
  • Special Needs Plans
  • Medicare Part D Plans
The conference will also appeal to:
  • Third-party administrators
  • Pharmacy Benefits Managers
  • Disease Management Companies
  • Technology companies
  • Government representatives
  • Public policy experts
Audience Demographics:
Hotel Info:
The Westin Arlington Gateway
801 North Glebe Road
Arlington, VA 22203
Phone: (703) 717-6200

We are pleased to announce that the Opal room block is open and we are accepting reservations. Please click on the ONLINE HOTEL RESERVATION link to book your room. The hotel will not accept individual call-ins.

Online Hotel Reservation
  • Rooms are available only to those participants who are registered conference attendees.
  • Rooms will not be guaranteed without a credit card.
  • Rooms are allocated on a first come first serve basis. Room types/rates are subject to availability.
  • The name on the form will be the name of the guest room.
Conference Registration Prices:
Early Bird Rate
Standard Rate
Medicare/Medicare Advantage/Medicaid Health Plans*, Physician Group, Hospital, Government Employees
First 100 FREE
$995
Behavioral Health, Vision Plans, Dental Plans, Radiology, Vascular Access, Rehabilitation Services, Diagnostic Laboratory Testing Services
$995
Service Providers
$1895
Register Now!
Group Discounts:
Register 3 people and receive 10% off ***
Register 4 people and receive 15% off ***
Register 5 people or more and receive 20% off ***

If you'd like to be invoiced, please submit your contact details on the registration page and select "Please invoice me" at the bottom of the page.

If you are interested in sponsorship, exhibiting, or speaking opportunities, please call 212-532-9898 or email information@opalevents.org
* TERMS & CONDITIONS
Subject to approval. To qualify you must be currently employed by a non-vendor company. Eligibility will be verified by conference producer. Opal reserves the right to allocate places and to refuse applications.

* Health plans must be CMS approved as Medicare, Medicare Advantage or Medicaid health plans

***Registrations must be made online on the same date. Discount will be applied after all registrants have been received.

Registration price reflects $100 online discount
Gold Sponsors:
Home Instead Senior Care inovalon Pyxis Health SolutionsYour Home Advantage
Exhibitor Sponsors:
EMSI Leprechaun=FlochecNeurometrixTactical Management
Media Partners:
Contexo MediaAdvantar LaboratoriesKong PushMedical News TodayThe Health Care M&A PharmaPhorumPharm Cast
Untitled Document
2013 Attendees & Agenda
Medical Director, ACCESS HEALTH CARE PHYSICIANS, LLC
Chief Compliance Officer, ACCESS HEALTH CARE PHYSICIANS, LLC
CEO, ACCESS HEALTH CARE PHYSICIANS, LLC
Care & Case Management Director, ACCESS HEALTH CARE PHYSICIANS, LLC
Medical Director, ACCESS HEALTH CARE PHYSICIANS, LLC
Quality Improvement Manager, AFFILIATED DOCTORS OF ORANGE COUNTY
MD, AGEWELL MENS INSTITUTE
CEO, ALL CLINICAL LABS/ A BETTER ME
Provider Representative, AMERICAN FAMILY IPA
Director of IPA Operations, AMERICAN FAMILY IPA
HEDIS Asst., AMERICAN FAMILY IPA
HEDIS Asst., AMERICAN FAMILY IPA
CEO, AMERICAN FAMILY IPA
Manager MRA, AMERICAN FAMILY IPA
RN Utilization Manager, AMERIGROUP
RN Utilization Manager, AMERIGROUP
Utilization Manager, AMERIGROUP COMMUNITY CARE
Case Specialist, Case Management, AMERIGROUP REAL SOLUTIONS
Financial Analyst, APPLECARE MEDICAL MANAGEMENT
Director of Health Services Management, ARCH HEALTH PARTNERS
Chief Medical Officer, ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM
Executive Director PHO and Managed Care, ARK-La-TEX HEALTH NETWORK
Manager, Medicare Rev Cycle Mgmt, AVMED HEALTH PLANS
VP, Quality Assurance Senior Auditor, BLUE SHIELD OF CALIFORNIA
Analyst, BLUE CROSS BLUE SHIELD OF MICHIGAN
Senior RIsk Adjustment Analyst, BLUE CROSS BLUE SHIELD OF MICHIGAN
Coding Analyst, BUCKEYE COMMUNITY HEALTH PLAN
CEO, BURNETT MEDICAL CENTER
Coding Quality Manager, Coding Initiatives, CALOPTIMA
Director, Pharmacy & Medicare Quality Inventive Program, CENTRAL HEALTH PLAN OF CALIFORNIA
Chief Medical Officer, CONTINUCARE CORPORATION
Director of Clinical MRA Administration, CONTINUCARE CORPROATION
President, Medical Director, CHESAPEAKE HOSPITALIST GROUP LLC
Medical Director, CHINESE COMMUNITY HEALTH PLAN
Director, CONCENTRA-HUMANA
Corporate Director of QA/RAPS, COVENTRY HEALTH CARE
Medical Director Special Programs, DESERT OASIS HEALTHCARE
Director of Coding Services, DESERT OASIS HEALTHCARE
Quality Program Coordinator, EASY CHOICE HEALTH PLAN
QI/CM Manager, EASY CHOICE HEALTH PLAN
Coding Supervisor, ESSENCE HEALTHCARE
Practice Administrator, FAIRFAX UROLOGY CENTER
Office Manager, FAIRFAX UROLOGY CENTER
Western Regional Sales Director, FLOCHEC
Enterprise Architect, FLORIDA BLUE
Business Analyst III, FLORIDA BLUE
Provider Auditor, FLORIDA BLUE
Provider Auditor, FLORIDA BLUE
former Chief Innovations Officer, FORMERLY FLORIDA BLUE
Coding Review Specialist - Risk Adj., GEISINGER HEALTH PLAN
Coding Review Specialist - Risk Adj., GEISINGER HEALTH PLAN
Coding Review Specialist - Risk Adj., GEISINGER HEALTH PLAN
Coding Review Specialist - Risk Adj., GEISINGER HEALTH PLAN
Audit Administrator, HEALTHPLUS OF MICHIGAN, INC
Auditor, HEALTHPLUS OF MICHIGAN, INC
Manager, Medical Audit, HEALTHPLUS OF MICHIGAN, INC
Manager Medicare Risk Adjustment, HIGH DESERT MEDICAL GROUP
Director, Finance and Revenue Management for Senior Products, HIGHMARK
Manager Medicare Risk Adjustment, HUMANA, INC
Consulting Leader, HUMANA, INC
Director, HUMANA, INC
MRA Education Manager, HUMANA, INC
Medicare Risk Adjustment Manager, ISLAND DOCTORS
Director of Medicare, INLAND EMPIRE HEALTH PLAN
Coding Educator, INTEGRANET
Director of Coding, INTEGRANET
MRR, INTER VALLEY HEALTH
Admin. Assistant, INTER VALLEY HEALTH PLAN
Financial Consultant, Risk Adjustment, KAISER PERMANENTE
Senior Manager, National Medicare Finance, KAISER PERMANENTE
Vice President, Risk Adjustment
Director of Utilization, Case Management, KINDRED HEALTHCARE
Coding Supervisor, LOVELACE HEALTH PLAN
Billing Manager, MARK S. DONNELL, MD
Director of HCC Compliance, MEDICAL AUDIT RESOURCE SERVICES, INC.
Chief of Radiation Oncology, MEDSTAR HEALTH
Senior Health Services Scientist, MEDSTAR HEALTH
Administrator, Medication Safety / PI, MEDSTAR GEORGETOWN UNIVERSITY HOSPITAL
Director of Pharmacy Services, MEDSTAR GEORGETOWN UNIVERSITY HOSPITAL
Business Intelligence Consultant, MEDSTAR WASHINGTON HOSPITAL CENTER
Director Medical Informatics, MEMORIAL CARE MEDICAL GROUP
Director of Contracting & Members, METRO HEALTH, INC./ MH GERIATRICS MANAGEMENT, LLC
MRA Specialist, METRO HEALTH, INC./ MH GERIATRICS MANAGEMENT, LLC
Medical Drug Officer, METROHEALTH, INC./ MH GERIATRIC MANAGEMENT, LLC
MD, METROHEALTH, INC./ MH GERIATRIC MANAGEMENT, LLC
Physician Assistant, METROHEALTH, INC./ MH GERIATRIC MANAGEMENT, LLC
President, METROHEALTH, INC./ MH GERIATRIC MANAGEMENT, LLC
Senior Compliance Representative - Medicare Part D Compliance Officer, NATIONAL RURAL ELECTRIC COOPERATIVE ASSOCIATION
Director, Risk Adjustment, NETWORK HEALTH PLAN
Director ACO, OCHSNER HEALTH SYSTEM
Strategic Program Manager, OCHSNER HEALTH SYSTEM
VP Strategy and Business Development, PARTNERS IN CARE FOUNDATION
Coding & Quality Assurance Team Leader, PCA MEDICAL GROUP
Assoc. Executive Director, PERMANENTE
Project, PRECISION HEALTH SYSTEMS
CEO, PREMIER MOBILE HEALTH SOLUTIONS
Medical Claims Review Nurse, ROCKY MOUNTAIN HEALTH PLANS
Medical Claims Review Nurse, ROCKY MOUNTAIN HEALTH PLANS
Program Director, SENIOR HEALTH INSURANCE ASSISTANCE PROGRAM
Executive Director of Coding Services, ST. JOSEPH HERITAGE HEALTH
Medical Director, STMG
Medical Consultant, TRIPLE-S SALUD
Health Services Admin., ASUF
Assistant US Attorney, U.S. ATTORNEY’S OFFICE
Investigator, U.S. ATTORNEY’S OFFICE
Director, UNITED
Quality Assurance Supervisor, UNITED HEALTH GROUP
Senior Vice President, UNIVERSAL AMERICAN
Manager, Risk Adjustment Coding, UPMC HEALTH PLAN
Executive Assistant to COO, VERSICK HEALTH RQI
AVP, VERSICK HEALTH RQI
AVP, VERSICK HEALTH RQI
Chief Medical Officer, VNSNY Choice Health Plans
Assoc. Executive Director, WOODHULL MEDICAL AND MENTAL HEALTH CENTER
Conference Day 1: Thursday, May 30, 2013
12:30 pm
Coffee & Registration
1:30 pm
Opal Events' Welcome
1:35 pm
Chair's Welcome, Audience Demographics

Chair:
Director of HCC Operations, BAKERSFIELD FAMILY MEDICAL
1:45 pm
Keynote Address:
The CMS Final Rate Notice & the How the HCC Model - And You - Will be Affected

Keynote Speaker:
Chairman, GORMAN HEALTH GROUP
2:45 pm
Coding for Medicare/Medicaid Dual Eligibles: Bringing Undercoded Risk Scores Up to Snuff

Speaker:
SVP, UNIVERSAL AMERICAN
3:30 pm
Afternoon Refreshment & Networking Break
4:00 pm
Keynote Armchair Discussion:
From The Coder's Perspective: RADV, Coding Teams, Approaches

Speaker:
Principal Consultant, PYXIS HEALTH SOLUTIONS
4:45 pm
From An Insurance Eye: Evaluating Coded Progress Notes
  • Chart review versus chart audit
  • Expectations of a chart review
  • Provider relations
Speaker:
Coding Supervisor, LOVELACE HEALTH PLAN
5:30 pm
Partnering with Providers:
Best Practices for System Organization & Workflow to Enhance HCC Data and Outcomes
  • Part 1: Creating strategic team solutions to improve workflow
  • Part 2: Developing a Payer/Provider Relationship Best Practices Checklist
    • Know who to contact at each facility
    • Know the request process for each provider
    • Minimize the time impact on the provider
    • Provide feedback on diagnostic coding
    • Offer training and incentives for proper coding
Speaker:
Manager Medicare Risk Adjustment, HIGH DESERT MEDICAL GROUP
Director of HCC Operations, BAKERSFIELD FAMILY MEDICAL
6:15 pm
Day One Closing Remarks and Cocktail Reception in the Exhibit Hall
Conference Day Two: Friday, May 31, 2013
8:00 am
Continental Breakfast & Registration
9:00 am
Chair's Welcome and Day One Re-Cap

Chair:
Director of HCC Operations, BAKERSFIELD FAMILY MEDICAL
9:15 am
Keynote
ICD-10: Why You Need it Now - And Why Waiting for ICD-11 Isn't The Answer
  • Developing criteria for identification
  • ICD-10 implementation strategies for health plans, physician groups
  • Legal/compliance aspects to consider

Speaker:
Director, Coding & Classification, AMERICAN HOSPITAL ASSOCIATION

10:15 am
Mid-Morning Refreshment & Networking Break
10:45 am
Spotlight Session: ~ Back by Popular Demand!

Lessons Learned from a RADV Audit Veteran

Speaker:
Medicare Revnue Management, FREEDOM HEALTH INC. (pending)
11:30 am
Readmissions Report: The Effectiveness of Home Care
This presentation will report on the results of a demonstration project testing the hypothesis that in-home care is effective in reducing unnecessary hospital readmissions. The demonstration, initiated in May 2012 and to be concluded in January 2013, involves 60 high-risk CHF patients discharged into home care. Clients are voluntary participants each receiving between 80and 100 hours of non-medical care delivered over 30 days. This program will offer the following information as developed and applied in the test:
  • Impact on readmission rate: Goal was to reduce readmissions by a minimum of 6 percent. (Mid-point result: 40% reduction in readmissions for all causes.)
  • Care model applied: Description of the care model utilized.
  • Care management model followed: Discussion of the care management process followed by participating hospital and care provider.
  • Caregiver training & engagement: Implication for and response to providing readmissions care for caregivers
Speaker:
Business Performance Manager, HOME INSTEAD SENIOR CARE
12:00 pm
Luncheon
1:00 pm
Chart Documentation In-Depth: Documentation's Impact on Reimbursement
  • Our speaker will bring redacted chart notes to go through a live audit.
Speakers:
Chief Compliance Officer, ACCESS HEALTH CARE PHYSICIANS, LLC
CEO, ACCESS HEALTH CARE PHYSICIANS, LLC
1:45 pm
HCCs and Star Ratings: Coding & Revenue Integrity
  • The impact of physician documentation and coding on Medicare's Star Ratings programmatic
  • Best practices developed and implemented
Speaker:
VP, Quality, Population Management & Behavior Health, BLUE SHIELD OF CA
2:30 pm
Using Benchmarks to Determine Compliance Risk
  • CMS and OIG: What triggers and audit
  • Tips for developing and implementing customized compliance programs
  • What coders can do to protect providers in the current audit environment
  • Top billing errors that raise red flags
Speaker:
 Director of Physician Services, HALIFAX HEALTH
3:15 pm
Conference Adjourns
Register:
Service Providers
$1,895.00
:
Behavioral Health, Vision Plans, Dental Plans, Radiology, Vascular Access, Rehabilitation Services, Diagnostic Laboratory Testing Services
$995.00
:
Medicare/Medicare Advantage/Medicaid Health Plans*, Physician Group, Hospital, Government Employees
$995.00
:
Pending Registrations
You have 1 registration pending.
Sub-Total: $537.00
    register now
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