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The Office of the Inspector General (OIG) issued a report earlier this year concluding that “hospitals are increasingly billing for inpatient stays at the highest severity level,” emphasizing that “stays at the highest severity level are vulnerable to inappropriate billing practices, such as upcoding.” The OIG recommended that “CMS [Centers for Medicare & Medicaid Services] conduct targeted reviews of MS-DRGs and hospital stay that are vulnerable to upcoding.” Essentially, the OIG is saying, “We have encouraged providers to compliantly code the complexity and severity of the Medicare population accurately. As a result of these compliant hospital efforts, we were shocked to learn that old people are sick and, by default, hospitals must be wrong.” However, right or wrong, increased scrutiny is coming to hospitals.Webinar Information:
- Date: Wednesday, May 5, 2021
- Time: 2:00 pm ET | 11:00 am PT
- Duration: 60 minutes
Why does this matter to Utilization Review, CDI/Coding, & Revenue Cycle leaders?
Because MS-DRG coding will likely become a significant issue for the OIG and RACs moving forward (CMS suggested that it would be sharinging these data with the RACs).
Join Versalus Health as we reveal a secret… the flaws in the OIG methodology are basic ones that are also extremely prevalent across hospital revenue cycle data analytics, nationwide.
Attend this webinar to learn:
- Why the methodology used by the OIG in its report is flawed: gain an in-depth understanding of the report analyses, findings, and repercussions
- How Utilization Review, Documentation, and Coding outcomes and data are interdependent and critical areas of the Clinical Revenue Cycle
- How the potential for additional auditor attention to Documentation & Coding can impact your organization’s efforts
- How to ensure compliance and audit defensibility of all appropriate Medicare DRG payments
Questions? Call us: 484.443.4656 or Email us: email@example.com.
Meet the Speakers
Robert R. Corrato, MD, MBA
Chief Executive Officer
Dr. Robert R. Corrato is Founder and Chief Executive Officer of Versalus Health. Before Versalus, Dr. Corrato was Founder and Managing Partner of Devon Hill Capital Partners (DHCP), a diversified healthcare investment firm. Prior to founding DHCP, Dr. Corrato was the Founder, Chairman and President & CEO of Executive Health Resources (EHR). In his roles at EHR, Dr. Corrato was responsible for driving the vision and strategy for corporate growth to best serve the healthcare compliance industry, growing EHR into the leading national provider of medical necessity compliance solutions that served the needs of over 2,000 hospitals, performed concurrent reviews on millions of Medicare short-stay cases, overturned thousands of Medicare denials and successfully defended scores of hospitals under investigation by the Office of the Inspector General (OIG) and Department of Justice (DOJ). Prior to founding EHR, Dr. Corrato held the post of deputy director of the Office of Health Policy and Clinical Outcomes at Thomas Jefferson University in Philadelphia.
Dr. Corrato earned his master of business administration degree from the Wharton School of Business at the University of Pennsylvania and received his medical degree from the Medical College of Pennsylvania.
Thomas McCarter, MD, FACP, FCPP
Executive Vice President & Chief Medical Officer
Dr. Thomas McCarter serves as Executive Vice President and Chief Medical Officer at Versalus Health. Prior to joining Versalus, Dr. McCarter was Chief Clinical Officer of Executive Health Resources (EHR) where he was responsible for clinical research, physician education, regulatory policy, and the rules used to adjudicate over 10 million medical necessity reviews for over 2,000 hospitals across the United States to achieve Medicare regulatory compliance and clinical appropriateness.
Dr. McCarter has served as Senior Vice President of Medical Affairs and Chief Medical Officer of Main Line Health System in Philadelphia, and as Vice President of Medical Affairs for Tenet Health System’s Pennsylvania Region. He served faculty positions at the University of Pennsylvania, Hahnemann University, Medical College of Pennsylvania, Geisinger Medical Center, and Drexel University School of Medicine. Dr. McCarter has extensive experience defending hospitals and health systems when under scrutiny by the Office of the Inspector General (OIG) and Department of Justice (DOJ).
Dr. McCarter received his medical degree from Hahnemann University School of Medicine and bachelor’s degrees in Biology and in Chemistry from the University of North Carolina at Chapel Hill, where he was a Morehead Scholar.
Jerilyn P. Morrissey, MD
Senior Vice President, Clinical and Regulatory Affairs
Dr. Jerilyn Morrissey is responsible for regulatory, private payer, and utilization management education for case management staff and physicians. Dr. Morrissey is passionate about using data and technology to help hospitals navigate complex Medicare regulations and understand payer practices and their impact on the hospital revenue cycle. Dr. Morrissey’s experience as a practicing physician, a Physician Advisor for a nationally recognized health system, and as a Director of Clinical Information for a national payer, afford her a unique perspective to solve utilization management’s evolving challenges.
Dr. Morrissey received a Bachelor of Arts in Biology from the Illinois Wesleyan University and her medical degree from the University of Illinois. Dr. Morrissey is currently a licensed physician in California.
Senior Vice President, DRG Revenue Integrity
Ms. Lisa Taylor brings over 25 years of healthcare services product development, operational, sales, and strategic client management experience. Before joining Versalus, Ms. Taylor was Senior Vice President of Data Mining and Audit for Equian. Prior to Equian, Ms. Taylor was Senior Vice President of Payment Integrity for Trover Solutions. In her role, Ms. Taylor was responsible for product design and delivery for data mining, coordination of benefits, hospital bill audit, DRG audit, and outpatient audit. Earlier in her career, Ms. Taylor served as Healthcare Audit Operations Manager for Cotiviti and as Vice President of Clinical Operations for Healthcare Recoveries, Inc.
Ms. Taylor has a Bachelor of Science degree in Financial Management from Clemson University.
Joseph R. Zebrowitz, MD
Dr. Joseph R. Zebrowitz is Founder and President of Versalus Health and has led the team in the development of an innovative approach to Two-Midnight Rule compliance. Prior to Versalus, he was Managing Partner of Devon Hill Capital Partners (DHCP), where he led the investment in several successful healthcare startups. Prior to DHCP, Dr. Zebrowitz spent 12 years as Executive Vice President and Senior Medical Director of Executive Health Resources (EHR), where he led the development of EHR’s compliance and revenue integrity products. Dr. Zebrowitz’s career focus has been on assisting hospitals in gaining a true picture of their compliance profiles through analysis and audit and advancing lasting solutions to provide enduring compliance and visibility. Prior to joining EHR, Dr. Zebrowitz founded Concuity, Inc. (formerly eHealthContracts), now part of the Advisory Board Company and served as its Vice President of Strategic Alliances.
Dr. Zebrowitz received his medical degree from Temple University School of Medicine and a bachelor’s degree in psychology from the University of Pennsylvania. He attended the Wharton School of Business at the University of Pennsylvania.