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Program Agenda

10:00 a.m. - 12:30 p.m.

As health care has evolved, demand has grown for a patient classification system that can be used for purposes beyond payment. Policymakers determined that the scope of the Diagnosis Related Group (DRG) system needed to be expanded to address patient severity of illness, risk of mortality, and resource intensity.

On December 1, 2009, All Patient Refined (APR)-DRGs were implemented for many New York State payers for Medicaid, Workers’ Compensation, and No-Fault payments. The APR-DRGs expand the basic DRG structure by adding four subclasses to each DRG.

Insight into APR-DRGs will look at the new APR-DRG methodology and include an overview, sample statewide historical data, and tips and tricks.

Also included will be a discussion, led by an expert physician, surrounding the importance of accurate and complete medical record documentation. This will focus on the impacts of proper documentation (the new watch word in revenue cycle management) and offer specific guidance as it pertains to APR-DRGs and the revenue recovery audit world hospitals must operate in.

Who should attend

Hospital staff from the following areas:

• Chief Medical Officers
• Medical Staff Directors
• Patient Financial Services
• Health Information Management
• Clinical Documentation Specialist
• Quality Management
• Compliance Officers

What you will learn

At the conclusion of this program, participants will:

• have a core understanding of the APR-DRG methodology;
• learn the core reimbursement formulas used by Medicaid and other payers using APR-DRGs;
• understand the relevant factors to being reimbursed appropriately for services paid under APR-DRGs;
• learn areas where documentation of patient conditions is especially important under APR-DRGs; and
• learn how to track and analyze case mix with APR-DRGs

Faculty

Eric Neihaus, Vice President, Health Information Management
Healthcare Association of New York State

Continuing Education Credits

There are no continuing education credits being offered for this event.

Registration

The registration deadline is March 27. Any questions regarding registration can be directed to Joan Stewart at jstewart@hanys.org, or by phone at (518) 431-7990.

Materials

• Sample facility-specific report