Surviving MAC, RAC and

ZPIC AuditsA comprehensive educational

workshop on pre and post payment audits.

The process for responding to an Additional Documentation Request (ADR) is the critical first step in preventing denials. This skill-building workshop will provide attendees with skills and the knowledge necessary for a solid response to any auditing entity that decreases risk of a denial. Further, it will educate attendees on the Appeals process, and the additional opportunities to getting a denial overturned.

Polaris Group’s LTC Training Institute — Surviving MAC, RAC and ZPIC Audits will provide strategies for managing the people, records, and process for responding to auditor’s, and appealing denials. Aspects of the various roles each person plays during this process includes coordination, preparation, documentation, and tracking. Preventing denials in the first place is part of a comprehensive compliance program as internal QA functions is a must. Each area will be covered providing specific, practical approaches to deal with the challenges in the appeals process.

Attendees will receive a comprehensive training manual that can be used as a resource in your facility as well as forms and procedures on CD which allows customization to fit your operational needs.

Surviving MAC, RAC and ZPIC AuditsA comprehensive educational workshop on pre and post payment audits.

Why THIS workshop is one of the best investments you can make this year:

• Interactivelearningformat– This workshop is designed to combine didacticinstruction and open discussion to facilitate connection between the topic and real-worldapplication of principles and practices. Participants are encouraged to actively engage in thelearning process.

• Smallclasssize–With a smaller group, more interactive activities are provided with allquestions answered to ensure optimal learning experience.

• ProgrammanualandCD–Each attendee receives a comprehensive program manualwhich includes all educational materials and small group activities with sample proceduresand forms which can be implemented in your facility.

• PolarisGroupexperience – Polaris Group has been an established expert providingconsulting and education to Long Term Care facilities for over 25 years.

Who should attend?• Administrators• DONs• MDS Coordinators• Medical Records Personnel• Business Office Personnel• Therapy Directors

This workshop is designed to provide you with the information and knowledge needed for responding to, and preparing for, pre and post payment audits of your Medicare claims. Content is designed to address the audit process while also providing you with the tools necessary for successful claim approvals.

REGISTER30DAYSINADVANCE and SAVE$100!

Call 800-275-6252 Ext. 233 to receive your discount!

Surviving MAC, RAC and ZPIC AuditsModule1• Medicare Overview

- Coverage Guidelines- Technical Requirements for Coverage- Documentation Requirements•Physician•Nursing•Therapy•Financial

-NationalCoverageDeterminations- Local Coverage Determinations

Module2• Current Audit Environment

- CMS Viewpoint- Contractor’s Viewpoint- Low hanging fruit

• CMS Contracting Entities or Referral Agencies- MAC- RAC- CERT- ZPIC- MIC- MFCU- HCFAC- SMP- DOJ- OIG- HEAT

Module2(Continued)•Audits

- Outside Agency•PredictiveModeling•MedicalReview

- Probe- Progressive Corrective Action

•ManualMedicalReview•PEPPER

- Internal•ComponentofoverallComplianceProgram•Investigations•SelfReferral,ornot

- Types•Automated•Complex

- Extrapolation•Investigations

- Qui Tam trigger- OIG- DOJ- ZPIC

day oneModule3•Additional Development Requests (ADR)

- How notified•FISS•Letter

- How to respond•Packet•Review•CoverLetter

- Internal process- Tracking- Responding Time Frames

Module4•Appeals Process

- The 5 Levels of Appeals•Redetermination•Reconsideration•AdministrativeLawJudge•MedicareAppealsCouncil•FederalDistrictCourt

- Opportunities of each- Process

•Common Reasons for Denials•Writing an Effective Appeal Letter

day twoSurviving MAC, RAC and ZPIC Audits

Module5•Preparing for your ALJ Hearing

- Coordinator’s Role•KeyIssues•Builddefenseofcase

- Position Paper- Affidavits- Supporting Documents

- CMS Participation- Discovery

Module6• Effective Prevention

- Triple Check•Whoshouldattend•Howoften•Whatisreviewed•Outcomeofreview

- Avoiding Technical Denials- Assessing your Documentation•ReviewNursingDocumentationand

what to look for•ReviewTherapyDocumentation•AffectingChange

Module7• Internal Audit Practicum

- Review Actual Clinical Record- Initiation to forms- Practice an actual Audit

Module8• Compliance Programs Place in LTC

- Review of ACA requirements forCompliance Program

- How Internal and External Audits fit intoCompliance Program

- Cost vs. Savings- ValueandBenefits- Code of Conduct- Compliance Officer’s Role- Compliance Committee- Legal Obligations

Registeronlineatwww.polaris-group.com

orcall800-275-6252Ext.233

VictorKintzhasover30yearsexperienceinthehealthcare industry working extensively in the post-acute arena. His work history includes Administration, Regional Management, and Consulting with areas of expertise in operations, billing, finance, rehabilitation, managed care and compliance including post payment audits. In addition to his other duties, he is the Team Leader for Polaris Group’s Independent Review Organization (IRO). He received his Bachelors in

BusinessAdministrationwithadoublemajorinMarketingandManagement,and holds his Masters Degree in Health Care Administration. In addition to being a Licensed Administrator, Victor is certified in Health Care Compliance byHCCA,asaResidentAssessmentCoordinator(RAC-CT)throughAANAC,and is a Certified Coding Associate (CCA) through the American Health Information Management Association (AHIMA). Currently he serves on the BoardofDirectors atSantiamHospital asPresident, and teachesHealthcareManagement for the University of Phoenix.

VictorKintz,MBA,CHC,NHA,RAC-CT,CCA

Continuing EducationCredits:

12ContinuingEducationCredits(CECs)forboth

administrators and nurses

Registration: Registertodayonline

atwww.polaris-group.comor

downloadregistrationformtoregisterbymailorfax.

Registrationdeadline:7daysbeforethescheduleddate for training program.

Earlybirddiscount$100offperperson

dates, location & hotel information

HotelInformation:All hotel information is provided on our website. Polaris Group has secured a limited number of rooms at

a discounted rate. Please make your own hotel reservations early by using the links provided on our website.

Pleasenotethatparticipantsareresponsibleformakingtheirownhotelreservations

Allclasstimesare8:30amto5:00pm.Coffeeorsodaprovided.Mealsareonyourown.

$100discountifregistered30daysinadvanceOnly$699perperson

CourseFeeis$799Thisfeeincludestwodaysoftraining,trainingmanualandCD.Refund/CancellationPolicy:Allrefundrequestsrequiredinwriting. Pleaserefertoourwebsiteforcompleterefundpolicyinformation.

Registeronlineatwww.polaris-group.com

orcall800-275-6252Ext.233

2014DATESand

LOCATIONS:Orlando,FLMay7and8th

Baltimore,MDSeptember23and24th

Workshop Location:

Workshop Dates:

Name:

Organization:

Title:

Address:

City:

State: ZIP:

Phone: Fax:

Email Address:

o A check for my workshop fee is enclosed (made payable to Polaris Group)o Charge my workshop fee to my credit card: o VISA o MC o AMEX CardNumber: Exp. Date: Three or Four Digit Security Code:

Name:(asappearsoncard)

BillingAddress:

City: State: Zip:

Upon receipt of this form and your workshop fee, we will send confirmation of your registration including hotel information and information about any manuals/texts required for the class. (this information is available at www.polaris-group.com)

workshop registration form

registration rates:o $699 early rate o $799 standard rate

Please mail or fax thecompleted form to:

Polaris Group3030 N. Rocky Point Dr., Ste. 240

Tampa, FL 33607P: 813-886-6500 • F: 813-886-6045

Toll Free: 800-275-6252 Ext. 233

Register 30 days in advance and save $100

Registeronlineatwww.polaris-group.com

orcall800-275-6252Ext.233

3030 N. Rocky Point Dr., Ste. 240Tampa, FL 33607