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Triple Check - Deconstructed and Renovated


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Triple Check - Deconstructed and Renovated

August 10, 2016
2 -3:30 pm
1 CEU for NHA, Nurses

Triple Check is the commonly used term to describe the processes used to ensure that claims are compliant and payable. For many facilities this process has become obsolete and is in need of renovation. Are you still doing things because 'that is how we've always done it?' Are you focusing on the proper elements? Is your internal communication in need of an intervention? Are you leveraging your computer system to eliminate steps and paper? This session is a deep dive into best practices, tools and techniques to help you initiate or amp up your current Triple Check process.

Learning Objectives:

Describe the underlying need for a strong Triple Check Process.
List the key elements to verify in a Triple Check Process.
Identify key communication points within your organization to ensure smooth processing.
Evaluate the tools available within your computer system to facilitate the process.
Develop useful checklists and other tools to ensure verification of necessary steps.
Design a strong Triple Check Process that can be utilized in your organization.


Kelly Sorenson, Healthcare Senior Manager
Dottie Hauman, Revenue Cycle Consultant
Shawn Philabaum, Clinical & Revenue Cycle Specialist
Triple Check - Deconstructed and Renovated

August 10, 2016
2 -3:30 pm
1 CEU for NHA, Nurses
Kelly Sorenson:
Consulting and Education in the following areas: Accounts Receivable, Billing Compliance and Audits, Billing System Implementation & Training, Budget Preparation and Anaylsis, Chart Audit and Reviews, Collections, Commercial Payer Billing, Compliance Program Monitoring, Corporate Compliance Assessments, Credentialing/Contract Negotiations, Managed Care Billing, Medicare and Medicaid Billing, Compliance/Governmental Relations, Reimbursement and Budgeting, IT System Conversions Kelly has over 20 years of experience in health care management and receivables. She has knowledge in both the payer and provider side of health care organizations with a concentration on pre and post audit chart reviews. Her comprehensive understanding of coding and compliance regulations provides skilled nursing homes, hospitals, physicians and insurers to move forward with globally integrated health care systems. She is a Certified Medical Office Manager who specializes in all phases of the revenue cycle as well as technology improvements and efficiencies.

Shawn Philabaum:
Shawn works with our long-term care clients in MDS Consulting and Reimbursement Training and in the following capacities: A/R Management Billing Compliance and Audits Certified Point Click Care Trainer Collections Compliance Program Monitoring Corporate Compliance Assessments Medicare and Medicaid Billing Policy and Procedure Development Provider Training/Education Regulatory Compliance/Governmental Relations Restorative Nursing Software Selection Analysis and Testing Shawn has an extensive background in post-acute care that includes, but not limited to, MDS Coordinator/Instructor, Restorative Nurse Supervisor, RAI Trainer, CQI/QM Specialists, Clinical and Reimbursement Consultant, and an expert Trainer for PointClickCare software. Shawn has over 18 years experience working in the post-acute and long term care setting and has extensive experience in Medicare and Medicaid reimbursement, MDS operational management, documentation and survey compliance as well. Shawn has significant experience as a billing manager for long term care facilities including Medicaid, Medicare, HMO billing and collection, and has significant experience and understanding of the clinical documentation as it relates to billing procedures. -RAC 3.0 Certified

Dottie Hauman:
My current duties with our Long-Term Care Facilities are training in the following areas covering multiple software products: -A/R Compliance and Audits with emphasis on Management -A/R Management -Billing & Collections (oversight and coordination of efficiencies) -Corporate Compliance Assessments -Managed Care Billing (along with Hospice) -Medicaid & Medicare Billing -Other Third-Party Billing -Reimbursement Procedures -New Business Office Manager Training -Policy & Procedure Development -Operational Process Improvements (between interdisciplinary teams) I have over 10 years experience with certification of Healthcare Billing and Office Management. I have experience in PointClickCare Certification, AOD and other billing softwares. This experience is supported by 16 years of financial strategy as a Senior Mortgage Loan Processor with a national financial institution. I am well-versed and keep current in the every-changing Medicare and Medicaid rules and regulations. -A member of the Ohio Senior Health Insurance Information Program (OSHIIP) Certified Counselor -NHA: Certified Billing and Coding Specialist -NHA: Certified Medical Accounting Assistant
CEUs & Other Education Requirements:

Each program is approved for one (1.0) hour of credit for nursing home administrators and nurses. Individual attendance will be monitored throughout the call. Only those attending the entire call will be awarded continuing education credit. All participants regardless of need for CEUs, will receive a certificate of attendance. This course is considered a self-study course by Ohio BELTSS. Administrators are reminded that BELTSS limits teleconference (home/self-study) credits to a total of ten (10.0) per renewal period. Administrators are required to complete a post-test immediately following the event with a passing score of not less than 80% prior to earning the 1 CEU.

How much does it cost?

Facilities will pay one low fee for an unlimited number of participants. However, the number and access code is valid only for one phone line/computer at the location registered with the Association. Any additional phone connections calling in will be billed the individual session registration fee.

Individual Session Fees: (prior to July 27)
Members: $55
Non Members: $130

Individual Session Fees: (July 27 and after)
Members: $75
Non Members: $175

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With Support from OHCA Champion Partners