Inpatient billing has been a source of frustration for O&P suppliers for many years, complicated by the different variables that can impact successful claim processing. O&P Insight will clarify the rules behind inpatient billing, explaining the “why” behind it as to what information you need to determine whether your claim will be paid and/or to whom the claim should be billed.
Learning Objectives
- What is consolidated billing and how does it affect claims?
- Knowing when to bill the payer and when to bill the inpatient facility
- Proper claim submission and denial resolution
Presented by: Michelle Wullstein, CPCO Manager of Compliance and Education for O&P Insight.
Presenters
Lesleigh Sisson, CFo, CFm
Founder, CEO of O&P Insight
Lesleigh Sisson, founder and CEO of O&P Insight, started her career in the orthotic and prosthetic profession in 1992. While working in O&P administrative and clinical support roles, Lesleigh recognized the desire to help businesses not only provide excellent patient care, but maintain a healthy, profitable operation. Over the years, Lesleigh has curated her experience to provide support across the spectrum of businesses that exist in the O&P industry, hoping to advance the profession through harmonizing continuity of care from manufacturing to patient care, and even the payer relationship. She is an American Board for Certification (ABC) Certified Fitter of orthotics and mastectomy and received the Sam E. Hammontree, CP Business Education Award in 2018. She is currently a published white paper author and is certified in Patrick Lencioni’s Working Genius curriculum, allowing her to enable others to leverage their leaderships skills and enhance their teams. Lesleigh helps independent O&P businesses to not only survive, but also to thrive in today’s challenging and ever-changing healthcare environment.
Michelle Wullstein, CPCO
Manager of Compliance and Education at O&P Insight
Michelle has been in the Medicare profession for 18 years and spent most of her career within Noridian Healthcare Solutions, the DME MAC for jurisdictions A and D. She began on the Part B Physician Services side with compliance, billing, customer service, and quality assurance and then transitioned into System Security. In 2011, she made the move to the DMEPOS Outreach and Education division, where she became specialized in orthotics and prosthetics. Michelle joined O&P Insight in 2018 as Lesleigh’s first team member and provides O&P specific medical policy, billing, documentation, and HIPAA compliance support to internal teams and clients. Michelle recently received her AAPC Certification as a Certified Professional Compliance Officer and is eager to help clients strengthen their compliance programs.
Susanne Kasza
Training and Development Project Manager at OPIE Software
Susanne Kasza has over 25 years of experience in the healthcare profession, providing, training, consulting, management, and implementation services, for a wide range of patient care organizations, throughout the United States, Canada, and Australia. She has been with OPIE Software since 2015 and uses her experiences, education, management, and problem-solving skills, to assist every person she works with. Susanne is part of OPIE’s Events and Education team and enjoys working with and celebrating the successes of our partners in the O&P Profession.