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WEBINAR: How to Audit 2010 Compliance

Presenter: Darlene D’Altorio-Jones, Strategist, Performance Improvement

IRF 2010 Regulations for Medicare Part A were not optional guidelines. Audits of charting with technical deficiencies can trigger full denial. If you are not auditing process, completion and appropriate information and timelines to expectations, you may be at risk for substantial losses. If in preponderance you are deficient, you may even risk licensure to operate and be paid under IRF- PPS. Attendees will be provided with templates not only for audit but also for writing rebuttals that will help to flag records for 2010 mandate ADRs (Additional Development Requests).

In part one, we review in detail how to audit records for compliance. For those on MediLinks installed after November of 2009; let’s review standard reports and workflow that can help and why documentation can assist in monitoring 100% of records not just a sampled few. Part two of our IRF rebuttal webinar series provides resources and instruction for writing rebuttals.

Following the webinar:

  • Participants will grasp the serious consequences in understanding the conditions of participation (C.O.P.) in an IRF as defined in the 2010 Guidelines and how they are monitored;
  • Participants can clarify expected baselines for measurement and adherence to medically necessary admissions and how documentation must support compliance to coverage criteria conditions to refute denial audits;
  • Participants will be provided tools and skills to enable self-audit at a level expected by either their FI/MAC or RAC auditors;
  • Attendees will be able to state time deadlines and documentation requirements that must be supported in the Medical Record and to apply a 1-5 rating of presence to the criteria.
  • Participants will be empowered to complete meaningful self-audits of the entire IRF throughput; admit to billing and demonstrate resources that back up measurement clarity.
  • Tools and Resources will be provided
  • Attendees will be able to set up surveillance and provide written rebuttals to support necessary documentation within a medical record that meets the criteria outlined in IRF Facility regulations.
  • Attendees will be exposed to how electronic documentation systems can/should provide discrete elements to track for enabled success in meeting clinical and physician charting mandates.
  • Attendees will be able to verbalize areas discoverable on automated vs. a manual review of the record; understanding how to deter red flags from occurring to protect THEIR MARGIN.

Who should participate?

Compliance Managers, Directors, Nursing/Therapy Managers, Rehab Physicians and Quality Improvement staff will benefit from attending.

Presenter bio:

As a Physical Therapist with an MBA in Healthcare Management, Darlene is a Strategist for Performance Improvement at Mediware, Darlene’s focus is to assist clients to utilize electronic documentation to its utmost potential in compliance, outcomes, revenue and efficiency. Working in rehabilitation medicine for more than 30 years, Darlene spent 12 years as a Director of Rehabilitation, with oversight of three post acute care service lines: acute rehabilitation, skilled and outpatient hospital-based services. She was instrumental in maintaining clinical adherence to IRF Federal Regulations and leading CARF and Joint Commission standards of practice. In addition, Darlene’s experience includes Quality Improvement Chair, Lean Healthcare training and serves as an active member of the Board of Directors for the Ohio Association of Rehabilitation. Darlene develops course content and blogs on federal guidelines for post acute admissions, level of care medical necessity, documentation, IRFPAI tool completion, and rapid throughput review for management process improvement.

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