NAPA 12th Annual Physician Advisors Summit

Whether new or experienced in the role, a critical look at the qualities and benchmarks that make for a successful Physician Advisor can help improve performance and efficiency in the position. In this in-depth workshop, learn what defines a Physician Advisor, explore how to measure success, and grasp the meaning of confusing territory and terminology.

• Review the responsibilities of a Physician Advisor that lead to success within the role
• Convey the role and boundaries of the Physician Advisor to medical staff and administration
• Determine annual goals that are progressive and achievable
• Inpatient length-of-stay
• Reduced readmission rates
• Physician education processes
• Denials management
• Two-Midnight Rule implementation
• Outline daily tasks to ensure efficiency
  • Number of claims to review
  • Concurrent case review
  • Interaction with other departments
  • Time spent in rounds
  • Time spent on physician education
  • Data review
  • What claim appeals to follow up on
• Explore the difficult territory and terminology that a Physician Advisor faces

As the shift towards lower cost and higher quality continues, organizations are ever more cognizant of the financial impact of every process and decision. In this workshop, learn effective ways to overturn denied claims to gain revenue.

• Explore how to integrate the clinical aspect into revenue cycle management within a health system to improve the bottom line
• Outline methods to change the culture within a claim appeals program without changing the structure
• Articulate a successful case to Medical Directors at different insurers to overturn the denial
• Discuss the clinical differences between Interqual and Milliman
• Write an effective letter of appeal using critical elements in the patient case
• Present an effective argument in front of an administrative law judge
• Hear about experiences peers have had speaking in front of an administrative law judge