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Pine Tree Chapter AAHAM

Pine Tree Chapter AAHAM. April Educational Meeting What You Need To Know In 2013 April 12th Jeff’s Catering 15 Littlefield Way Brewer, ME Register online at www.aahamme.org Or use the attached form. Pine T ree Chapter AAHAM. Program Schedule 8:00 – 8:30 Registration

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Pine Tree Chapter AAHAM

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  1. Pine Tree Chapter AAHAM April Educational Meeting What You Need To Know In 2013 April 12th Jeff’s Catering 15 Littlefield Way Brewer, ME Register online at www.aahamme.org Or use the attached form

  2. Pine Tree Chapter AAHAM Program Schedule 8:00 – 8:30 Registration 8:30 – 8:45 Welcome/Presidents Updates 8:45 -10:00 Observation Hide & Seek – Uncovering Revenue Hidden in Plain Sight Penny Brennan, ROI 10:00 -10:15 Break/Networking 10:15 -11:15 Fraud and Abuse – Medicare A & B Bob Aube/Gail O’Leary 11:15 - 12:15 Maine Community Health Options – Coop Insurance Information Bill Schulz, Dir of Provider Network Operations 12:15 – 1:00 Lunch/Networking 1:00 – 2:30 2013 OIG Work Plan Maggie Fortin/Jan Hodgdon, BBN 2:30 – 3:00 Penquis Cap Updates Marcia Larkin 3:00 – 3:30 Wrap Up/Evaluations

  3. Pine Tree Chapter AAHAM Name_____________________________________ Name_____________________________________ Name_____________________________________ Facility Name______________________________ Phone ____________________________________ Email Address ______________________________ ________________________________________ • Enclosed: • #_____________ AAHAM Member Registrations at $60.00 • # _____________ AAHAM Non-member Registrations at $85.00 • $ _____________Total Enclosed Please Register ONLINE at WWW.AAHAMME.COM Or send registrations and payment information to: Vickie Heath Franklin Hospital 111 Franklin Common Farmington, ME  04938 Make checks payable to: Maine Chapter of AAHAM

  4. Observation Hide & Seek • Uncovering Potential Revenue Opportunities and Compliance Issues Hidden in Plain Sight • Penny Brennan, ROI • You Will Learn • How to accurately capture Observation hours based on Medicare Rules and Regulations • What “warning signs” to look for on Observation claims that could indicate Compliance problems • What to check for when you see Condition Code 44 • How to identify opportunities for additional revenue by using simple audit techniques such as • What coding “pairs” to look for • Identifying understated billing units • modifiers • and many more

  5. MEDICARE PART B FRAUD & ABUSE • Medicare Part B Fraud and Abuse • Robert Aube This presentation will define "Fraud" and "Abuse" and review Laws and Mandates & Penalties and Sanctions. We will discuss the Compliance Contractors; PSCs/ZPICs, Comprehensive Error Rate Testing (CERT) and Recovery Audit (RA). We will also cover unacceptable billing practices, improper waivers and will provide 10 tips for protecting your practice.

  6. CO OP INSURANCE INFORMATION • Maine Community Health Options • Bill Schulz • An overview of MCHO development efforts to-date and what we are doing to prepare for our January 2014 effective date. In partnership with our provider network and plan members, we will reduce healthcare costs by improving access to care with a focus on best practice and care integration, and by supporting community resources to promote the health and wellbeing of our members

  7. 2013 OIG Work Plan • Maggie Fortin & Jan Hodgdon • Baker Newman Noyes • The Office of Inspector General (OIG) for the U.S. Department of Health & Human Services (HHS) released in the Fall its annual Work Plan. The Plan lists 25 projects that examine CMS payments to hospitals under Part A and Part B. The presentation will focus on these initiatives and speak to what a Hospital can do to mitigate or prevent this type of government audit.

  8. PATIENT TRANSPORTATION Marcia Larkin, Department Director of Community Support, has twenty years of experience providing transportation services to the residents of Maine. Marcia began her tenure at Penquis in 1994 serving as a Dispatcher in the transportation department. At Penquis, Marcia has held the positions of Lead Dispatcher, Dispatch Supervisor, and Division Manager. In 2004, Marcia was appointed Director of the Community Support Department and is responsible for oversight of the Department’s Lynx Transportation. Whether it’s transportation to medical appointments or ensuring rural residents get their shopping and banking done, Marcia’s team is there to make it happen. Last year, LYNX transportation covered over 9 million miles and 383,000 trips. • Penquis Cap • Marcia Larkin • Bus Passes • Covered Services • Reimbursement • TAP • Low Income • General Public • New Freedom • ADA • MTA • Ride to Wellness

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