Tracks


Sessions presented at PaRADigm are based on the RBMA Common Body of Knowledge. Listed below are the tracks available along with the corresponding session.

Billing Track

Monday, April 15, 2019

11 a.m.-noon
The Merit-based Incentive Payment System and Data Registries: How to Win in 2019
Barbara F. Rubel, MBA, FRBMA, and Claudia Murray, RCC

This session will cover the key components of performance year three under the Merit-based Incentive Payment System (MIPS) and will help attendees assess their compliance with the requirements. During the session, the speakers will address MIPS terminology, what you need to know about QCDRs and CMS’ expectations. A case study of practical interventions will be shared and discussed.

At the conclusion of the session, the attendee will be able to:
  • Determine the increase in performance that is required from 2018 to 2019 and the impact of the cost performance category.
  • Evaluate how your MIPS performance is different under a MIPS Alternative Payment Model.
  • Distinguish the importance of mining your billing data to evaluate measures for viability, i.e. those that will yield the maximum 10 points and are not “topped out.”

1-2 p.m.
Facilitate Revenue Flow– Solidifying the Patient-to-Provider Experience
Cleve Shultz

Learn in an interactive presentation the best practices to facilitate revenue flow and solidify the patient-to-provider experience in an environment where more provider revenue is riding on patient responsibility. Discover how the right solutions utilizing carefully engineered, intelligent patient statement and letter delivery, payment, and value-added solutions will drive reimbursement and boost revenue flow. This informative and fun session filled with audience participation will benefit radiology practice administrators, billing managers, office managers, medical billing companies, and more.

At the conclusion of the session, the attendee will be able to:
  • Evaluate how an intelligent patient statement garners results and reduces patient confusion, therefore, freeing up valuable FTE time.
  • Recognize the benefits of offering patients multiple payment choices and learn how to implement these options.
  • Identify which results proven value-added solutions every practice should be utilizing to lower costs, improve office efficiency, and facilitate revenue flow.

2:45-3:45 p.m.
Coding Evaluation and Management Services
Katharine Krol, MD, FSIR, FACR

In today's health care policy environment, payments are shifting away from diagnostic testing and procedures to Evaluation and Management (E/M) services. Radiology, especially interventional radiology, provides E/M services and should capture those revenues through correct E/M billing. Interventional radiology practices are finding that a clinical practice is critical to being able to build the program they want and to do this they need to provide E/M services. This applies to some DR practices as well. This session will provide data that supports the financial viability of clinical services in an IR practice and will teach coders the basics of how to bill E/M services for radiology. A clinical practice is a source of both revenue and practice building. Additionally, hospitals, carriers and policy makers all look at billed E/M codes when deciding who really takes care of patients.

At the conclusion of the session, the attendee will be able to:
  • Define why E/M coding is important for radiology.
  • Show the economic benefits of E/M coding for radiology.
  • Apply the basics of how to bill E/M codes for radiology.

Tuesday, April 16, 2019

11 a.m.- noon
"But Will it Get Paid?"
Karna Morrow, CPC, RCC, CCS-P

“But will it get paid?” is not an uncommon question within the world of health care. Payors continue to trim the list of payable diagnosis codes and conditions for reimbursing procedures. Managing the way in which the medical record is morphed into codes while being compliant requires sincere finesse. This session is dedicated to building a solid bridge between revenue and compliance; that space where dollars are found without becoming the next major headline.

At the conclusion of the session, the attendee will be able to:
  • Identify specific areas within the workflow that may be unintentionally dropping dollars thru the cracks.
  • Learn how to leverage the code set to reduce Unlisted Procedure Codes and additional documentation requests.
  • Manage expectations of both patients and providers by keeping the communication lines open.

1:30-2:30 p.m.
The Impact of Artificial Intelligence on Health Care RCM
Navaneeth Nair

The rapid development and improvements in AI algorithms and their ability to impact health care will have significant implications for revenue and payment processes. The advent of mainstream AI has been impacting a wide range of health care arenas including clinical decision making, precision medicine, and imaging. One area that has the potential immediate value is the application of AI to enable physicians to get paid consistently and accurately. AI will enable accurate requirements for pre-authorizations, improved coding, reduced gaps and billing errors. AI will proactively identify denials and help to prioritize AR to identify feasibility of both payer and self-pay collections.

At the conclusion of the session, the attendee will be able to:
  • Learn how AI is impacting health care.
  • Review the impact of AI on RCM processes.
  • Recognize how AI can be made actionable in RCM today.

3:15-4:15 p.m.
Thumbs Up, Thumbs Down: Evaluating Billing Performance
Pat Kroken FACMPE, CRA, FRBMA and Jennifer Kroken MBA

The session presents guidelines used to evaluate billing performance for an in-house billing department, as well as for a third-party billing company. Most of the time the same measures apply—but when do they vary and why? What is realistic to expect in terms of performance compared to RBMA key indicators and when should the alarm bells go off? Recognizing the adage, “if you’ve seen one radiology practice, you’ve seen one radiology practice,” but there is still a logical progression regarding what to review and where problems are most likely to occur. During the session, the presenters will give you an view from a consultant’s perspective of what they see when reviewing a radiology practice or billing company, so attendees can better apply similar concept when looking at their own practices for making improvements.

At the conclusion of the session, the attendee will be able to:
  • Define billing performance in different settings.
  • Apply a logical progression when evaluating key performance measures.
  • Determine realistic expectations.

Wednesday, April 17, 2019

9:45-11 a.m.
Predictive Analytics: Taming The Uncertainty
Jason Cavallaro, MBA, CPC

Predictive analytics utilizes a variety of techniques from data mining, statistics, modeling, machine learning, and artificial intelligence to analyze current and historic data to make predictions about future or otherwise unknown events. This presentation will explore advanced and unique approaches to assess and control charges and forecast collections. Advanced denial reporting will also be explored. Learn to apply analytic techniques and build predictive models to help manage your revenue cycle.

At the conclusion of the session, the attendee will be able to:
  • Identify differences between types of predictive models.
  • Build and evaluate collection forecasts.
  • Apply modeling techniques to monitor and control charge flow.

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