The Expanding Role of the Physician Advisor in HCQM Sunday, November 1, 2015 - Sunday, December 31, 2017    CME Provider: American Board of Quality Assurance and Utilization Review Physicians › Deborah Naser 6640 Congress Street New Port Richey, Florida (FL) 34653 United States   Toll Free: 800.998.6030 Phone: 727.569.0190 Fax: 727.569.0195   Visit the CME Provider Webpage ›   Description: The role of the physician advisor is evolving in today's health care systems. This course will describe the history of the physician advisor and the physician leadership roles that can be fulfilled throughout the care continuum including: transitions of care support, interdisciplinary team management and communication, the transition to ICD-10, determining patient status and level of care, Medicare appeals and medical necessity reviews, and many more facets impacting the quality of care patients receive. At the conclusion of the online course, participants will be able to: *List the areas of potential influence for the experienced and well-trained physician advisor *List and describe three classifications of the basic types of medical necessity reviews *Explain the advantages of the physician advisor and care manager Dyad leadership model *Explain the importance of the CMS Title 42 of the CFR as related to healthcare *Summarize the CMS requirements for Inpatient and Outpatient level of care *Describe the application of the Two-Midnight Rule as a requirement for inpatient level of care for Medicare beneficiaries *List the CMS Conditions of Participation requirements for issuing a Condition Code 44 *Describe how the definition of observation services differs from inpatient status, both from the perspective of CMS and commercial payers *Outline the advantages to a well-organized multi-disciplinary approach to managing complex discharges *Identify and contrast several current pay for performance programs *Describe two established models for implementing an effective transitions of care discharge plan *List and describe the five main stages of the RAC Appeal process *Contrast the differences between Palliative Care, End of Life Care, and Hospice Care *Outline the guidelines governing the CDI Query process *Discuss the nuances of ICD-10 coding, risk factor, and condition categories *Outline the tools and building blocks of an effective organization This course is intended for Physicians of all specialties, Nurses, and Other Health Care Professionals with appropriate CME credit and nursing contact hours offered for each profession. The American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. ABQAURP designates this online enduring material for a maximum of 4.25 AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity. ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 4 contact hours through the Florida Board of Nursing, Provider # 50-94. This program is approved for Category 2 credit by the American Osteopathic Association.   Visit the CME Course Webpage ›     Instructors: Members of the CME Committee, Planners, and Faculty have disclosed to ABQAURP any relevant financial relationships. No relevant financial relationships or conflicts of interest exist in regard to the content of this activity. Amanda Berglund Larry Field, DO, MBA, CHCQM Alvin Gore, MD, CHCQM Jessica L. Gustafson, Esq. Larry T. Hegland, MD, CHCQM Ronald Hirsch, MD, FACP, CHCQM Edward Hu, MD, CHCQM Elizabeth Lamkin Hossain Marandi, MD Steven Meyerson, MD, CHCQM Abby Pendleton, Esq. Bernard H. Ravitz, MD, CHCQM Ronald J. Rejzer, MD, CHCQM Michael Salvatore, MD, CHCQM Howard A. Stein, DO, CHCQM Nick Ulmer, MD, CPC Daniel Zirkman, MD     CME Credit: Physicians:  4.25 Hours Physician Assistants:  4.25 Hours Self Assessment Module (SAM):  Yes Specialty Audience: Allergy / Immunology    Anesthesiology    Dermatology    Emergency Medicine    Family Medicine    Genetics    Internal Medicine    Medical Ethics    Neurology    Obstetrics / Gynecology    Ophthalmology    Otolaryngology    Pathology    Pediatrics    Practice Management    Preventative Medicine    Psychiatry    Quality Assurance    Radiation Therapy    Radiology    Risk Management    Surgery     RADLIST Course #15449