Empowering Practices: Implementing Internal Coding Audits & Quality Improvement Plans-Webinar Slides

Webinar Slides

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The document "Empowering Practices: Implementing Internal Coding Audits & Quality Improvement Plans" from the Home Centered Care Institute provides comprehensive guidelines on improving healthcare practices through enhanced coding audits and quality improvement plans. Here are the key points:<br /><br />**Disclosures & CME Credit**: The planners and faculty for this educational activity have no financial relationships with companies producing or selling healthcare products. The activity is accredited by the ACCME and provides a maximum of 4.50 AMA PRA Category 1 Credits.<br /><br />**Presenters**: The session involves experts from various domains, including Brianna Plencner, Odessa Hoinkis, and Ada Tapper.<br /><br />**Session Objectives**: The goals include identifying tools for internal audits, discussing the value of peer auditing, and reviewing cases where quality documentation and appropriate coding support patient-centered care.<br /><br />**Importance of Quality Documentation and Coding**: Proper documentation ensures accurate payment, reflects patient complexity, and plays a crucial role in interoperability. Compliance and team integrity are essential for practice sustainability.<br /><br />**Factors Impacting Revenue**: Revenue-related factors include a strong intake process, correct coding, claim submission, and denial management. Expenses involve salaries, infrastructure, and vendor contracts.<br /><br />**Balancing Efficiency and Quality Care**: Developing practice standards, managing in-person vs. telehealth visits, and leveraging technology are crucial. Specific guidelines support medical necessity and quality care documentation.<br /><br />**Compliance Standards**: Based on the OIG Compliance Program Guidance, practices should implement internal monitoring, appoint a compliance officer, provide proper training, develop open communications, and enforce disciplinary standards.<br /><br />**Practical Tips for Audits**: Reasonable sample sizes should be used, billing trends compared, and risk areas identified. Ongoing education and development opportunities should be structured.<br /><br />**Case Studies**: Examples include Bergen Geriatric Care focusing on behavioral health, cognitive assessments, and value-based care, and ACT Health Solutions, emphasizing transitional care management and remote patient monitoring.<br /><br />**Resources & Support**: Various resources, such as the Medicare Learning Network and OIG compliance materials, are available to enhance compliance and practice sustainability.<br /><br />The document concludes with an invitation to utilize the HCCIntelligence Resource Center for further support and information on home-based primary care (HBPC).

Keywords

Internal Coding Audits

Quality Improvement

Healthcare Practices

AMA PRA Category 1 Credits

Compliance Standards

Revenue Management

Telehealth

Patient-Centered Care

OIG Compliance Program

Home-Based Primary Care