Strategies for using Condition Code 44 and Part B Provider Liable Correction

 

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  • Date: Wednesday, July 31, 2019
  • Time: 2:00 pm ET | 11:00 am PT
  • Duration:  60 minutes

In some instances, a physician may order a Medicare beneficiary be admitted to the hospital, but upon review of the case, the hospital’s utilization review (UR) committee may determine that inpatient level was not supported by physician documentation. In these situations, Centers for Medicare and Medicaid Services (CMS) has provided hospitals with two methods to correct this error: Condition Code (CC) 44 and Part B Provider Liable Correction. These two methods are compliant and are supported by CMS regulations and guidance; both methods have similar reimbursement; and both approaches have arguments for and against as it relates to efficiency, error, and payment.

To help clarify the confusion, compliance and revenue cycle experts, Drs. Robert Corrato, Joe Zebrowitz, Tom McCarter will:

  • Review the pros and cons for Condition Code 44 and Part B Provider Liable options
  • Review when and how to use Condition Code 44 and Part B Provider Liable
  • Consider the patient implications of each methodology
  • Discuss examples with revenue implications for both methodologies

We hope you can join us for this webinar!

Questions? Call us: 484.443.4656 or Email us: info@versalushealth.com

Meet the Speakers

 

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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.

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Joseph R. Zebrowitz, MD

President

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.

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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 chemistry from The University of North Carolina at Chapel Hill.