Advanced Issues in Establishing Provider-Based Clinics

Duane C. Abbey

Duane C. Abbey

Duane C. Abbey, Ph.D., is a management consultant and president of Abbey & Abbey, Consultants, Inc. that specializes in health care consulting and related areas. His firm is based in Ames, Iowa. Dr. Abbey earned his graduate degrees at the University of Notre Dame and IowaStateUniversity specializing in mathematics and computer science. Dr....
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Pre-recorded
90 Mins
Duane C. Abbey

Understanding the Provider-Based Rule (PBR) can be a tall order, especially as changes in the physician supervision and reimbursement rules add confusion. Not only do hospitals’ provider-based operations face unique billing and operations issues, but PBR ambiguities—from multiple PBR-status criteria to joint-use/time-share spaces to signage requirements—make compliance a real challenge. Learn to weigh the economic benefits and compliance concerns of provider-based operations—and make smarter choices for your hospital and clinic.

Join expert speaker Duane C. Abbey, Ph.D, CFP as he explains the key differences between freestanding and provider-based clinics, and the economic advantages of the latter. He will teach you to set fees for your clinic, conduct patient relations, and effectively organize your medical staff. Abbey will walk you through all the complex PBR compliance details, including how to: apply the physician supervision requirements for outpatient services, abide by reporting requirements, use CMS-855 enrollment forms, qualify clinics that are outside the 35-mile default limit, and audit your clinic operations. 

The 2017 Outpatient Prospective Payment System (OPPS) rule changed how non-exempted off-campus provider-based departments will be paid. And both Section 603 of the 2015 Bipartisan Budget Act (BiBA) and Section 16001 of the 21st Century Cures Act have significantly affected the establishment and payment systems of provider-based clinics. Be sure your clinic is up-to-date and being paid appropriately! 

After attending this audio event, you will be well equipped to implement all PBR-specific billing and coding requirements—and be audit-ready at all times. By the end of this information-packed session, you will have the tools you need to understand how federal legislation and billing requirements converge to impact how your clinic will be paid.

Webinar Highlights


This program will teach you how to:

  • Qualify clinics outside the 35-mile default limit
  • Apply provider-based reporting requirements and fill out the CMS-855 forms
  • Clarify which criteria must be met in order to qualify for provider-based status
  • Improve operations, such as setting fees and structuring staff
  • Gauge how PBR ambiguities may be affecting your operations and how to gain clarity
  • Get started on upgrading your  provider-based clinic’s coding and billing practices
  • Determine how and when to audit your provider-based operations to remain compliant with CMS

Who Should Attend


All persons involved with provider-based clinics will benefit from this session, including:

  • Claims transaction and compliance personnel
  • Financial analysts
  • Operating officers
  • Clinic administrators and managers
  • Coding personnel
  • Chargemaster personnel
  • Nursing staff
  • Physicians/practitioners
Event Registration
$199.00
$299.00
$299.00
$349.00
$299.00
$199.00
$299.00
$199.00
$199.00
$299.00
$299.00
$199.00
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