Gain access to three, two-hour virtual sessions on Life Care Plan Costing.
Session 1: Understanding the Basics of Healthcare Cost
Data, Rebecca Busch
Participants
will be able to:
- Explain healthcare billing concepts, rules, and codes
- Explain how to interpret a healthcare claim form
- Describe why the data on a healthcare claim form is reliable
Participants will be able to:
- Demonstrate the process of utilizing the medical coding system and healthcare databases to create estimates for future surgeries and/or medical procedures by walking the participants through several costing scenarios
- Describe how the medical coding system paints a picture of a medical procedure, such as who performed the procedure, what was performed, why it was performed, where it was performed, and what was included to perform the procedure.
- Explain how to use healthcare pricing databases.
Participants will be able to:
- Determine how to select appropriate cost data for a life care plan
- Discuss the use of clinical judgment in life care plan costing
- Provide case examples of questions in depositions related to life care plan costs
Rebecca Mendoza Saltiel Busch, RN, CCM, FIALCP, CFE
Rebecca Mendoza Saltiel Busch, RN, CCM, FIALCP, CFE, is the founder and CEO of Medical Business Associates, Inc. (MBA), established in 1991 as a minority, woman-owned Medical Data Auditing and Healthcare Consulting firm. In addition to authoring six books, Rebecca has been granted seven U.S. data analytic design patents. Recognized as an expert in her field, Rebecca has developed countless life care plans and reviewed hundreds of thousands of medical charges for whether they are Usual, Customary and Reasonable (UCR). She currently provides technical investigative, audit, and review expertise to various government agencies, health care providers, and legal clients.
Ann Maniha, RN, CLCP, CMC
Sylvia “Ann” Maniha is a Registered Nurse, Certified Life Care Planner, and Certified Medical Coder. She obtained her CLCP in 1998 and CMC in 2004. In the early 2000’s, Ann began developing a methodology pertaining to the use of the medical coding system and healthcare pricing databases to create surgical and medical procedure pricing scenarios for the life care plan. She has written several articles on the subject in addition to several presentations/webinars. Her background includes experience in life care planning, medical case management, research and specialty nursing care including orthopedics, post-anesthesia care unit, outpatient surgery, medical-surgical, substance abuse and psychiatry. She developed “Life Care Planning for the PC, a life care planning software for Microsoft Word and Corel WordPerfect. She has published three articles pertaining to medical coding and pricing associated with life care planning. A member of the International Academy of Life Care Planning (IALCP), a section of the International Association of Rehabilitation Professionals (IARP) and the proud recipient of the “Cheryl L. Jasper Memorial Recognition Award” in September 2015.
Credits: 6.0 CEs of the following credits have been applied: ABVE, CCMC, CDMS, CLCP-MSCC, CRCC, CVE-CWA-CCAA, CNLCP (Pending Approval)