Inpatient Per Diem Hospital Engagement Meeting Tuesday, June 25, 2019 2:00 PM – 3:00 PM Location: Webinar Room Conference Line: 1-877-820-7831 Passcode: 294442# For more information contact: Elizabeth Quaife at elizabeth.quaife@state.co.us 1
Welcome & Introductions • Thank you for participating today! • We are counting on your participation to make these meetings successful • We are a small group so we highly encourage logging onto the Conference Line for discussion or speaking via Webinar. Conference Line: 1-877-820-7831 Passcode: 294442# 2
GROUND RULES FOR WEBINAR • WE WILL BE RECORDING THIS WEBINAR • Please speak clearly when asking a question/comment and give your name and hospital • We are going to try to avoid muting the phone lines to encourage conversation, so please don’t: • Put us on hold • Drive in your car w/window open while listening • Sit in a noisy location • Be cautious of side conversations and language (we can hear you and it is being recording) 3
Where are we? State Plan Amendment (SPA) • Approved June 11, 2019 with effective date July 1, 2019 Medical Services Board (MSB) • Initially reviewed December 2018 with adoption in January 2019 • Returned to MSB March 2019 for language clarification, adopted April 2019 System Update for July 1, 2019 Launch • Estimated System implementation ASAP • Rebilling will be required 4
Rates Posted Rates were originally posted May 29, 2019, however, two Psychiatric Hospitals were left off. Rates were reposted to include these two hospitals on June 25, 2019. No changes were made to LTAC, Rehabilitation or Spine/Brain Hospitals' Per Diem Rates. 5
Implementation Claims with an Admit date prior to July 1, 2019 and discharge on or after July 1, 2019 will be paid using 2 different payment methodologies. • Dates of service through 6/30/2019 will be paid using the APR-DRG methodology • Dates of service starting on 7/1/2019 will be paid using the new per diem methodology. Since system updates are still under way we do not have final guidance on how these claims will be processed. Additionally, we would like to hear feedback on the following items related to claims that span the implementation date: • Transfer codes • Reporting for uncovered days • Medicare crossover claims • Any other items? Please continue to bill as normal until direction has been provided. 6
Future Meetings Currently, we do not anticipate any additional meetings until after implementation is in full swing and we have more to present on future modifications to the per diem. However, if unanticipated complications arise from implementation and a meeting is needed for clarification we will call one as quickly as possible Meetings will be announced via: • Email • Hospital Stakeholder Engagement Meeting Webpage • Provider Bulletin • Preceding Hospital Stakeholder Engagement Meeting (when possible) 7
ANY MORE QUESTIONS??? Anymore questions/concerns? Can also email me at Elizabeth.quaife@state.co.us if anything comes to mind. 8
Elizabeth Quaife Specialty Hospital Rates Analyst Elizabeth.Quaife@state.co.us 9
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