The role of the physician advisor is evolving in today's health care systems. This course describes the role of the physician advisor in health care quality and management and the physician leadership roles that can be fulfilled throughout the care continuum. These roles include transitions of care support, interdisciplinary team management and communication, determining patient status and level of care, participating in Medicare appeals and medical necessity reviews, and many more facets impacting the quality of care patients receive.

At the conclusion of this activity, attendees should be able to:
Describe the roles and areas of potential influence for the experienced physician advisor.
Summarize the CMS requirements for Inpatient and Outpatient level of care.
Describe how the definition of observation services differs from inpatient status.
Explain the basic types of medical necessity reviews.
Evaluate CMS' Conditions of Participation requirements for issuing a Condition Code 44.
List and describe the main stages of the RAC Audit process.
Faculty includes:
David Gates, MD - Consultant
Hemant Gupta, MD, MSc., CHCQM-PHYADV - Consultant and Previous Medical Director & Lead Physician Educator, Sound Advisory Services
About the Authors
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 online activity.

ACCREDITATION & CREDIT
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 enduring material for a maximum of 3.0 AMA PRA Category 1 Credits™. Physicians should claim only the 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 3.0 contact hours through the Florida Board of Nursing, Provider # 50-94.
This program is approved for Category 2 credit by the American Osteopathic Association.
This activity is valid from May 2, 2023, through September 30, 2025.

This standalone course is also included as a portion of the Core Body of Knowledge (CBK) online course. They may be taken individually to earn incremental CME/CE credits, recertification credit, or towards the Physician Advisor sub-specialty designation. However, HCQM Exam candidates taking the CBK course would not benefit from the similar material nor be able to claim credit for both courses for initial certification.

Pricing:
Diplomate Members $90.00
Professional Members $110.00
Non Members $130.00