Author: Nancy Robinson

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Highlights of this episode include:

• What is this webinar about?
• Key takeaways
• Recap of the whole series
• Who can benefit from this webinar

Kelly Wisness: Hi, this is Kelly Wisness. We’re pleased to welcome back Kristin DeGroat, Besler Holdings’ Chief Legal Officer. In this episode, Kristin will provide us with a glimpse into Besler Holdings’ next and final webinar in its Medicare Cost Report Appeals and Reopening series. This one focused on Best Practices. This will be live on Wednesday, July 22nd at 1 PM Eastern Time. Welcome back and thank you for joining us, Kristin.

Kristin DeGroat: Thank you for having me again.

Kelly: All right, well, let’s go ahead and jump in. So, this webinar will focus on best practices. Can you give us a quick review of what we can expect in the way of best practices?

Kristin: Yes. Navigating a Provider Reimbursement Review Board appeal requires rigorous adherence to strict rules and regulations. And because of that, there are some extremely valuable best practices that you need to think about when you’re filing these appeals. The portal and the deadlines are not just suggestions, they are requirements. So, navigating those in terms of best practices and setting forth how you remember when things are due and that kind of stuff in terms of an appeal is really important. But also important is the reopening process, ensuring that you adhere to the max deadlines, and that’s the Medicare Administrative Contractors deadlines and requirements. They are different. You do things a little bit differently. So, you need to think of how you handle that and getting those filed as well. And then just in general, CMS in general, there’s so many different parts and pieces that lead into appeals and reopenings. So just trying to set yourself up for success in terms of getting these filed and following the protocols, and basically trying not to irritate the board and the MAC are very important in this process.

Kelly: Yeah, that sounds like solid advice, Kristin. And we always love best practices, so this is going to be a really great webinar. So, what do you think is going to be some key takeaways from the webinar?

Kristin:Kind of what I just said about the being able to categorize or set up maybe calendaring or other avenues to ensure that you’re meeting the deadlines. And also cataloging, keeping your documentation together in a way that somebody else can understand. We all get caught in the, I’ve done it, I’ve looked at it so much, then we forget that people aren’t exactly like us and don’t read things exactly the same. So, cataloging that in a way that others can understand and appreciate, I think, will be the greatest takeaway.

Kelly: Yeah, that sounds like a great takeaway too. So, this is the last in our Medicare Cost Report Appeals and Reopening’s webinar series. Can you do a quick recap of the first two, and how does this one fit in?

Kristin: So, the first one was a deep dive into the PRRB and the rules and the deadlines, the timeliness, the amount of controversy. Those strict requirements and then we talked a little bit about the reopening requirements. And so, all of that together then led us to, well, what are the most common issues? That was the second webinar. And we did the deep dive into the most common issues, and we gave the status, kind of case law where they were sitting right now, and what we expect, or hope, maybe, is a better word, the outcome will be for those cases. So, the third one will definitely not hit the issues and the updates. So really, if you want to learn about the most common issues, updates, that one you’ll have to go watch if you didn’t join us for the second webinar. Hopefully, you’ll join us for the taped version, so to say. But I think this third one really will kick and tie to the first one where we kind of went through everything, but this will just be a little bit different approach. So maybe the lingo might be repeated, and I might forget to give the definition for my lingo. So, I will do my best. But I invite you to look at the whole series together, because I do think the whole thing together really makes sense.

Kelly: Yeah, creates that complete picture, right?

Kristin: That’s correct.

Kelly: Yeah. So, do you have to watch the first two or watch them in order for this webinar’s content to make sense? I mean, or are they standalones?

Kristin: I don’t know that they’re necessarily standalones completely. The first one did go through in detail what we’re going to talk about in best practices. And it gave a little overview of the issues. But really, that second webinar, the diving into those issues and really telling you what the status is, where they are right now, I think really is a standalone. But in order to get there, you had to meet all of the requirements. And you have to have the best practices to ensure that you’re really not irritating your audience. You want to make sure that you’ve complied and have done things showing not to be rude, right? When the board says you have 20 days to file this, don’t do it on the 21st day. It’s just as simple as that. Just following the rules and some best practices to help get you through. The other thing is appeals aren’t new, reopenings aren’t new. So, there is a lot. 30-plus years of going through the process has really, I think, laid out for us a nice, seamless transition from, “Here’s the rules,” to, “Here’s the issues, and here’s how you keep the goodwill going with your issues and your appeals, and even your reopenings.” So we’re going to talk a little bit more about reopenings, probably, in this third series, because I think the max concerns about how we approach issues and appeals, I think it’s something that we really need to take heed of because they are the ones that are going to help you settle your cases and help push these cases through. So, I think I want to do a little bit more focus there.

Kelly: Okay, that makes a lot of sense. Looking forward to that one. So, who do you recommend attend this webinar? Who is the target audience?

Kristin: Really, anyone in reimbursement. If you are filing a cost report or even thinking about an appeal, and you’re probably filing reopenings, so anyone doing those that has always wondered, “Well, I wonder why I did my reopening this way, and I didn’t get a really good response,” or, “Wow, I thought this would move faster. I’m not sure what I did wrong. I thought I compiled the evidence.” So, I think really focusing on that and moving through that process. And maybe that’s it. Maybe you’re someone new to reimbursement. This would be a great way to kind of experience, okay, so this is what I need to do. And it’s not all going to be about rule following. Some of it is just common courtesy.

Kelly: Yeah. That makes a lot of sense, yeah.

Kristin: Oh, I was just going to say I hope everyone can join the webinar. I’m really excited about this one. I think it kind of gives you more of a– let’s me put some personal flair on it and what I’ve experienced over the years.

Kelly: Yeah, love that. Well, thanks so much for joining us, Kristen, for giving us this glimpse into Besler Holdings’ free webinar, Medicare Cost Report Appeals and Reopenings Best Practices, that we’re going to do live on Wednesday, July 22nd, at 1 PM Eastern Time. And as a bonus, you can also earn CPE. Thanks again, Kristin.

Kristin: Thank you. Have a great day, Kelly.

Kelly: Thank you. And thank you all for joining us for this episode of The Hospital Finance Podcast. Until next time…

[music] This concludes today’s episode of The Hospital Finance Podcast. For show notes and additional resources to help you protect and enhance revenue at your hospital, visit besler.holdings/podcasts. The Hospital Finance Podcast is a production of Besler Holdings.

If you have a topic that you’d like us to discuss on The Hospital Finance Podcast or if you’d like to be a guest, drop us a line at update@besler.com.

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