This presentation will summarize some of the
key changes and challenges associated with
the Medicare Outpatient Prospective Payment
System and Ambulatory Payment
Classifications as released in the Final
Rule in November 2009. These changes will
likely include changes to the physician
supervision requirements as well as changes
to APC reimbursement for payable drugs, the
growing impact of quality reporting, outlier
policy changes and other modifications to
the APC rules.
Jean Russell, MS, RHIT, CIRCC
Partner
Epoch Health Solutions, LLC
Richard Cooley
Epoch Health Solutions, LLC
Jean Russell
Jean Russell has over thirty years of
healthcare and information system
experience. Her areas of expertise include
healthcare reimbursement modeling and the
Medicare outpatient and inpatient
prospective payment systems (APCs, APGs and
DRGs), as well as Charge Description Master
(CDM), admission status reviews, outpatient
coding, inpatient coding, compliance, case
mix analysis and medical record data quality
reviews. Jean’s education includes an M.S.
from the University of Houston in Biomedical
Engineering with a minor in Information
Systems; a B.S. from Colgate University in
Biology; and her RHIT from the independent
study program through the American Health
Information Management Association. Jean is
also a Certified Interventional Radiology
coder through AAPC.
Richard Cooley
With ten years in healthcare consulting, Mr.
Cooley has developed an expertise in
hospital outpatient and inpatient coding,
admission criteria reviews, billing,
reimbursement and compliance. His areas of
expertise include Medicare reimbursement for
the Medicare Outpatient Prospective Payment
System (OPPS) with special focus on
Laboratory, Pharmacy, Injections and
Infusions, Emergency Room, Observation,
Radiology, and Clinical specialties. He is a
certified inpatient and outpatient coder
with AHIMA. Richard has a B.A. from Hobart
College, majoring in English and Chemistry.
