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: 

1. To Understand Why Coding, Billing and Reimbursement Is Different for the ED?
2. To Appreciate Special Documentation Requirements for the ED
3. To review the need for developing a special ED compliance plan.
4. To discuss the current and evolving requirements for EMTALA compliance.
5. To review the definitions and conditions for EMTALA and how these concepts apply to coding and billing.
6. To compare and contrast EMTALA with the Conditions for Participation (CoPs).
7. To understand the special coding and billing requirements for the ED relative to EMTALA.
8. To appreciate the provider-based clinic interface to EMTALA.
9. To address special issues such as freestanding EDs.
10. 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
   1. EMTALA Compliance
   2. Coding, Billing and Reimbursement Compliance
   3. Special ED Considerations
   4. ED Documentation
   5. Observation and Associated Services
   6. Special Payment Processes
2. EMTALA Basics
   1. Definitions
   2. On-Going EMTALA Rule Changes
3. EMTALA Compliance
   1. EMTALA Survey Process
   2. EMTALA Compliance Problem Areas
4. Evolution in EMTALA Rules & Regulations
   1. Special Services Hospital Transfers
   2. Community Call Programs
   3. Qualified Medical Persons
   4. State Operations Manual - Interpretive Guidelines
5. Coding, Billing and Reimbursement for the ED
   1. Special Coding and Billing Requirements for the ED
   2. Coding and Billing Policy and Procedure Development
   3. Non-Physician Providers (NPPs) in the ED
   4. Joint Services Between Physicians and NPPs
   5. EMTALA Interface to Coding/Billing
6. Special ED Situations
   1. Provider-Based Clinics – EMTALA Requirements
   2. Hospital Clinics Deemed as Dedicated EDs
   3. Written Compliance Plan Relative to EMTALA
   4. 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