Full course description
Location Virtual
PrerequisiteNone
Full Schedule Thursday, November 6 from (5:30 PM - 7:30 PM) EST
FacilitatorZachary Pruitt, PhD, MHA, FACHE and Sandra Miller
Description
Participants will explore foundational topics in clinical documentation, billing, and revenue cycle management.
Practical guidance will be provided on avoiding common coding errors, optimizing coding, leveraging Advanced Practice Professionals (APPs) under "incident to" billing regulations, and tracking revenue cycle metrics. The session will also introduce managed care contracts and the physician’s role in value-based payment models.
By the end of the session, participants will be better equipped to align their clinical practice with operational and financial best practices in today’s evolving healthcare environment.
Learning Objectives At the end of this course, participants should be able to:
- Describe key components of the physician practice revenue cycle, including billing, coding, and collections.
- Explain how diagnosis-related groups (DRGs), clinical procedural terminology (CPT) codes, resource value units (RVUs), and capitation and value-based care Hierarchical Condition Categories (HCCs) impact reimbursement and physician compensation.
- Identify common documentation and coding mistakes that lead to billing denials or underpayments.
- Differentiate between services billable by physicians versus those billable "incident to" using APPs or auxiliary clinic staff.
- Apply business metrics relevant to physician practice performance, such as net collection rate, accounts receivable aging, denial rates, and payer mix.
About the instructors
- Zachary Pruitt, PhD, MHA, FACHE is a Professor at the University of South Florida College of Public Health where he teaches health services management, quality management, and healthcare finance. He co-authored the textbooks, Healthcare Quality Management: A Case Study Approach and Health Services Management: Competencies and Careers, both from Springer Publishing, Inc.
- Sandra Miller is a Senior Compliance Coordinator at Tampa General Hospital System. She currently teaches physician assistants regarding the business of healthcare at the University of Tampa. At TGH, she is responsible for physician education for coding, clinical documentation, regulatory updates, and audit preparation. Sandra is responsible for serving as the “Provider Compliance Program Coordinator,” supporting Tampa General Medical Group and the TGH network of physicians.