Catalog

The Expanding Role of the Physician Advisor in HCQM
Online
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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 module, attendees should be able to:
*Describe the roles and areas of potential influence for the experienced physician advisor
*List and describe three classifications of the basic types of medical necessity reviews
*Explain the importance of the CMS Title 42 of the CFR as related to health care
*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
*Identify and contrast several current pay for performance programs
*Describe established models for implementing an effective transitions of care discharge plan
*List and describe the 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
Faculty includes:
Larry T. Hegland, MD
Ronald Hirsch, MD, FACP, CHCQM
Edward Hu, MD
Elizabeth Lamkin, MHA, ACHE
Charles Locke, MD, CHCQM-PHYADV
Brian A. Moore, MD, FACEP, CHCQM-PHYADV
Bernard H. Ravitz, MD
Howard A. Stein, DO, CHCQM
Nick Ulmer, MD, CPC
Daniel Zirkman, MD
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 4.0 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 4.0 contact hour(s) 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 November 9, 2020 through August 31, 2023. (Previously valid: February 15, 2018 through November 8, 2020 and reviewed November 8, 2020.)
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 $150.00
Professional Members $170.00
Non Members $210.00
Credits awarded per Session. See individual Sessions for further details.
Credits awarded
Name
Sub type
Value
Certificate awarded

About this item

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 module, attendees should be able to:
   *Describe the roles and areas of potential influence for the experienced physician advisor
   *List and describe three classifications of the basic types of medical necessity reviews
   *Explain the importance of the CMS Title 42 of the CFR as related to health care
   *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
   *Identify and contrast several current pay for performance programs
   *Describe established models for implementing an effective transitions of care discharge plan
   *List and describe the 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

Faculty includes:
Larry T. Hegland, MD
Ronald Hirsch, MD, FACP, CHCQM
Edward Hu, MD
Elizabeth Lamkin, MHA, ACHE
Charles Locke, MD, CHCQM-PHYADV
Brian A. Moore, MD, FACEP, CHCQM-PHYADV
Bernard H. Ravitz, MD
Howard A. Stein, DO, CHCQM
Nick Ulmer, MD, CPC
Daniel Zirkman, MD

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  4.0 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 4.0 contact hour(s) 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 November 9, 2020 through August 31, 2023. (Previously valid: February 15, 2018 through November 8, 2020 and reviewed November 8, 2020.) 

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 $150.00
Professional Members $170.00
Non Members $210.00

Course/Activity Information

This course is intended for Physicians of all specialties, Nurses, and Other Health Care Professionals with appropriate CME / CE credit offered for each profession.

All participants must achieve a final assessment score of at least seventy percent (70%) for recertification and continuing education credits. You have 60 days to complete the course after ordering.

This activity is valid from November 9, 2020 through August 31, 2023. (Previously valid: February 15, 2018 through November 8, 2020 and reviewed November 8, 2020.)

 

 

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