Educatio

n

Commitment

Compliance

AR Systems, Inc.

www.RACSummit.com

The NATioNAl RAC SUMMiT

Physician Advisor & UR Team Boot Camp

Onsite:

July 22 – 24, 2013 Chicago, il • Hyatt Regency - O’Hare Airport

Online: In your own office or home live via the Internet with 24/7 access for six months

BRoNze GRANToR:

MediA PARTNeRS:

BooT CAMP ToPiCS:• BestPracticeHospitalCDIProgram• CDI,ICD10,andthePA’srole• TheComplianceOfficerPerspective• TheRoleofCaseManagement• Structure/FunctionofaPAProgram• Front-EndWork:FromERtoaBed• HandoffChallengesfromtheER• ConcurrentandDailyUR-PAReview• TrackingandTrendingPatterns• ThePARoleinPhysicianEducation• CaseStudies:INPT,OUTPT,orOBS?• PA-UR—PreventingaPattern ofDenials• ThePARoleontheAppealsTeam• LearningtodoGrassrootsAdvocacy

CONTINUING EDUCATION CREDITS: Continuing education credit is available forphysicians,nurses,andcoders.Seepage6ofthebrochurefordetails.

ChAiRDay Egusquiza, President, AR Systems, Inc.

FACULTyPatricia Cruz, RN, ADN, ACM, RAC Coordinator, Presbyterian Intercommunity Hospital

Ernie de los Santos, Consultant and Creator, The RAC Shadow

Jeffrey E. Epstein, MD, Medical Director, Quality, Case Management and Resource Utilization, Stamford Hospital

Jeffrey Farber, MD, MBA, Chief Medical Officer, Mount Sinai Care, LLC; Associate Professor, Brookdale Dept of Geriatrics and Palliative Medicine; Director, Appeals Management and Clinical Documentation Improvement Departments, Mount Sinai Medical Center

Pamela Foster, APSW, MBA, ACM, Director, Care Coordination, Case Management and Social Services, Mayo Clinic Health System

Larry T. Hegland, MD, Chief Medical Officer, Ministry Saint Clare’s Hospital, The Diagnostic and Treatment Center

Angie Roberson, RN, BSN, CPUM, ACM, Director, Case Management & Transfer Center, Spartanburg Medical and Village Hospital

Michael A. Salvatore, MD, FACP, Physician Advisor, Beebe Medical Center

E.G. “Nick” Ulmer, Jr., MD CPC, Vice President, Clinical Services and Medical Director for Case Management, Spartanburg Regional Health System

Marcia Widmer, MPP, CPC, Director of Compliance and Audit, North Shore Medical Center, Inc., Partners HealthCare System, Inc.

Ignacio Zarate, MD, Physician Advisor, Presbyterian Intercommunity Hospital

Co SPoNSoRS:

A Hybrid Conference,

Internet Event & Training

ToolSee page 3

BEST PRACTICES FROM PRE-ADMISSION TO APPEAL

Co-Produced by the National RAC Summit and AR Systems, Inc.

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OVERVIEW

TheNationalRACSummitserieshasalwaysofferedaRACCertificateProgramintheformofanoptionalcoursewithintheconferenceforattendeeswishingtotakeadeeperdiveintotheSummit’ssubjectmatter.In2013theSummitis

pleasedtooffertwodifferentsetsofcertificateprograms–oneinconnectionwiththeJulyPhysicianAdvisor-URTeamBootCampwithaspecificfocusonthoserelation-ships,andapairofprogramsinDecember—oneBasicandoneAdvanced,asin2012—inconnectionwiththeEighthNationalRAC(andMAC)Summit.

The July 2013 RAC Certificate Program curriculum and requirements are as follows:

• Completepreconferencereadings(asneeded,upto4hours).

• Completeonlinetrainingmodules(asneeded,preparedbyDavisWright Tremaine/Deloitte&ToucheandbyTheRACShadow/AppealAcademy (upto3hours).

• Attendthepreconference(required—3hours).

• AttendtheentireRACBootCamp(required—11.5hours).

• Successfullycompletethepost-conferenceonlineexamination (required—upto1hour).

WHOSHOULDPARTICIPATE?Thosewhoareinterestedinunderstandingandworkingsuccessfullyinensuringproperdecision-making,documentation,coordinationofduties,andresponsetopotentialdenialsregardingpropertreatmentandsiteofserviceforpatients.HospitalRACliaisons,nurses,physicianadvisors(PAs),emergencyroomclinicians,compli-anceofficers,CFOs,medicalcodingandbillingstaff,patientaccountsmanagers,casemanagers,utilizationreview(UR)committeemembers,andotherfinancialandauditingpersonnelareprimecandidatesforthecertificateprogram.Groupdiscountsencourage participation by an entire RAC team.

LEARNINGOBJECTIVESThepurposeoftheJuly2013RACCertificateProgramsistogiveparticipantstheun-derstandingandtoolsnecessarytocreateandnurtureeffectiveteamworkbetweenthehospital’sURfunctionanditsphysicianadvisorfunction,whetherthelatterisbasedonainternalPAmodeloranexternalmodel.Thiswillensurethatthehospitalalways“getsitrightthefirsttime”whenitcomestopatientdocumentationandplacement as a proactive, preventive strategy against denials by aggressive auditors.

THERACCERTIFICATEPROGRAM

PRoGRAM CoMPleTioNThosewhosuccessfullycompletetheprogramrequirementsandpassthefinalexaminationwillreceiveacertificateofcompletion.Candidatesintheprogramhave90daystotaketheexamandhavethreeattempts.Ascoreof70%orbetteronexamisrequiredtoearnthecertificate.

FREqUENTLyASkEDqUESTIONSIs the RAC Certificate Program a professional certification program?

Itisnot.TheprogramconstitutesanattempttoorganizeafocusedcurriculumaroundspecificRACimplementationstrategiesandissues,whilegivingevidenceofsuccessfulcompletionofthatbodyofknowledgethroughtheissuanceofacertificateofcompletion.

Please describe the post-meeting online examination.

Thepost-meetingexaminationisa40-questiononlineexaminationbaseddirectlyuponthefacultypresentationsinthepreconferenceandthemainBootCamp.Can-didatesmaytaketheexaminationatanytimeduringtheninety(90)daysfollowingtheconferenceandhaveonehourtocompleteitoncecommenced.Threeattemptsareallowed,withnewquestionsrotatingthroughtheexamination.Candidatesmustscoreseventypercent(70%)ormoretocompletetheprogram.

Has any other conference offered a comparable certificate program?

yes,thequalityColloquiumhasofferedaPatientSafetyCertificateProgramforthepastfouryears.SimilartrainingprogramshavebeenofferedinconnectionwiththeNational Medical home Summit, the National Population health and Care Coordina-tionColloquium,andtheNationalMedicareReadmissionsSummit.

This certificate is evidence that

has successfully completed the

RAC CERTIFICATE PROGRAM

Offered at the National Physician Advisor-UR Team Boot Camp

July 22-24, 2013 in Chicago, IL

ANExAMPLEOFA CoRPoRATe RAC CERTIFICATEPROGRAM

Group discount Allows Multiple StafftoPursueRACCertificates

WHOSHOULDATTEND?

ThePA-URTeamBootCampisdesignedasaverypractical,hands-on,highlyinteractiveexperienceforhospitalleadersandmanagers.Nojustsittingaroundlisteningtotalking

heads.WewilluseanAudienceResponseSystemtodosomepoll-ingandasksomequestionsaswegoalong,giveeveryoneashortfunquizattheendofeachday,arrangeforhostedinformaldinnerswithcolleaguesattheendofDayI,setupsingleissuebreakfasttabletopicsonthemorningofDayII,andassignhomeworkintheformofcasestudiesaboutinpatientvs.observationfordiscussionoverlunchonDayIIandpresentationlater,plustherearefacultypanelsandaudienceq&Athroughout.Sowhoshouldattend? Hereisanon-exclusivelist:

• ChiefExecutiveOfficers(agoodPA-URprogramwillsavemoneyfromavoidabledenials)

• ChiefFinancialOfficers(agoodPA-URprogramwillsavemoneyfromavoidabledenials,maybelotsofmoney)

• ChiefMedicalOfficers(ifyoudon’thaveaPA,learnhowtorecruitandtrainone,whetherinternalorexternal;ifyoudohaveone,learnhowtomakehim/hermoreeffectiveinpartnershipwithyourERstaff,yourURstaff,yourhospitalists,andyournursingstaff)

• CorporateComplianceOfficers(learnhowtomaketheROIcasetothethreepeoplelistedabove)

• HospitalCorporateCounsel(learnwhatandwhentochallenge,andwhatworks...andwhatdoesn’t)

• ExternalAffairs/GovernmentAffairsManager(ifyouhaveone—youshouldbemeetingwithyourMemberofCongressonthisstuff)

• Andofcourseallofthefollowing:

• RACliaisons

• staffnurses

• physicianadvisors

• utilizationreviewcommitteemembers

• casemanagers

• emergencyroomclinicians

• medicalcodingandbillingstaff

• CDIstaff

• ICD10staff

• patientaccountsmanagers

• otherfinancialandauditingpersonnel

Butdon’tjustsendonerep.WehavereducedthegroupdiscountrateforhospitalsandhealthsystemsinthefirstEarlyBirdperiod.SendyourRACliaison,yourPA,andanurse/casemanager(oranycombinationor3ormore)beforeMay10for$595each.Estimatethecostofregistration,travel,andahotelgrouprateof$145againstthecostofonedeniedinpatientclaim.(Seetheword “ROI”above.)JoinusinChicago.Thismightbeyourbesthospitalinvestment in 2013.

SAVE THE DATE!

eiGhTh NATioNAl RAC (ANd MAC) SUMMiTThe Leading Forum on Recovery Audit Contracting (RAC) ProgramsMedia Partners: Harvard Health Policy Review and Health AffairsCo-located with Seventh National Predictive Modeling Summit, Fourth National Medicare Readmissions Summit, and Fifth National Comparative Effectiveness Summit

december 4 – 6, 2013 Hyatt Regency Crystal City • Arlington, VAwww.RACSummit.com

A Hybrid Conference,

Internet Event & Training

Tool

THEPHySICIANADVISORANDURTEAMBOOTCAMP

ThepaceofhospitalauditsbyRACandMACcontractorsinMedicarehasneverbeengreater,andnowincludepre-paymentreviewsaswell.TheStatesarerampinguptheirownMedicaidRACcontractors, and Medicare Advantage plans and now commercial insurers are adopting aggressive

auditingtacticstocompoundtheburdenonhospitals.Hospitals’rightfulappealsofthisgrowingbodyofdenialsinturnthreatenstocompletelyoverwhelmanunderstaffedcollectionofAdministrativeLawJudges.Neverhasitbeenmoreimportantforhospitalsto“getitrightthefirsttime”whenitcomestoproperdocumentationofmedicallynecessarypatientcareandproperdecisionsregardingwhetherapatientmeetsthecriteriaforaninpatientadmissionorshouldplacedintoObservationstatusortreatedin an outpatient setting.

ThisiswherethePhysicianAdvisorandURTeamBootCampcomesin.Overthecourseofthreedays,inahighly interactive learning environment, the Boot Camp will teach participants:

• howtocreateandsupportaneffectiveURprogram

• howtodevelopaPhysicianAdvisorprogramappropriatetothehospital’ssize

• howtoconstructaneffectivepartnershiprelationsipbetweenthetwofunctionstoensure properdocumentationandsiteofservice

• howtocommunicatetheimportanceofthispartnershiptoothers

Thefocuswillbeonallstepsintheprocess—(1)gettingthepatientfromERtoabed;(2)concurrentanddailyreview;(3)dealingwithdenials;(4)managingappeals;and(5)engagingingrassrootslegisla-tiveadvocacy.TheBootCampwillalsoincludeapreconferenceonCDIandICD10issuestoroundoutthetraining.Especiallynow,whenitissoimportantto“getitrightthefirsttime,”thisisamusteventforhospitalstaff,andhighlydiscountedratesforhospitalteamsmakeitpossibleforalloftherightpeopleto attend.

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PARTiCiPATioN oPTioNS TRAdiTioNAl oNSiTe ATTeNdANCeSimply register, travel to the conferencecityandattendinperson.

PROS:subjectmatterimmersion;professionalnetworkingopportunities;facultyinteraction.

At your office . . .

. . . or home

LIVEANDARCHIVED iNTeRNeT ATTeNdANCeWatchtheconferenceinlivestreaming video over the internet and at your conve-nienceatanytime24/7forsixmonthsfollowingtheevent.

Thearchivedconferenceincludesspeakervideosandcoordinated PowerPoint presentations.

PROS:Livedigitalfeedand24/7Internetaccessforthenextsixmonths;accessibleintheoffice,athomeorany-where worldwide with internet access;avoidtravelexpenseandhassle;notimeawayfromtheoffice.

Onsite

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TUESDAy,JULy23,2013

BooT CAMP oPeNiNG SeSSioN — BUildiNG The UR-PA PARTNeRShiP TOENSUREPROPERSITEOFSERVICE

7:00 am Registration Opens Welcome Coffee

8:00 am Welcome and Overview Audience Response System Questions

Day Egusquiza, President, AR Systems, Inc., Twin Falls, ID (Chair)

8:15 am Why Make a Change? The View from the Compliance Officer

Marcia Widmer, MPP, CPC, Director of Compliance and Audit, North Shore Medical Center, Inc., Partners HealthCare System, Inc., Salem, MA

8:45 am The Role of Case Management in Achieving Successful Reform

E.G. “Nick” Ulmer, Jr., MD CPC, Vice President, Clinical Services and Medical Director for Case Management, Spartanburg Regional Health System, Spartanburg, SC

9:30 am The Structure and Function of a Physician Advisor Program, Both Internal and External

Larry T. Hegland, MD, Chief Medical Officer, Ministry Saint Clare’s Hospital, The Diagnostic and Treatment Center, Weston, WI

10:15 am BREAK

10:30 am Step 1 — Front End Work: Getting the Patient from ER to a Bed — Best Practices for UR at the First Point of Patient Contact

Day Egusquiza, President, AR Systems, Inc., Twin Falls, ID

Pamela Foster, APSW, MBA, ACM, Director, Care Coordination, Case Management and Social Services, Mayo Clinic Health System, Eau Claire, WI

11:15 am Handoff Challenges from ER to Hospitalists and Attending Physicians

Jeffrey E. Epstein, MD, Medical Director, Quality, Case Management and Resource Utilization, Stamford Hospital, Stamford, CT

Michael A. Salvatore, MD, FACP, Physician Advisor, Beebe Medical Center, Lewes, DE

12:00 pm Working Lunch (Attendees will be given actual case studies to discuss over lunch to determine Inpatient vs. Observation vs. Outpatient status, reporting their conclusions in the afternoon session)

MONDAy,JULy22,201312:00 pm Registration Opens

PRECONFERENCE:CLINICAL DOCUMENTATION IMPROVEMENT, ICD10, AND THE PHYSICIAN ADVISOR – UR TEAM PARTNERSHIP (Registration optional)1:00 pm Welcome and Overview of the Issues

Day Egusquiza, President, AR Systems, Inc., Twin Falls, ID (Chair)

1:15 pm Clinical Documentation Improvement from a Hospital Perspective

Patricia Cruz, RN, ADN, ACM, RAC Coordinator, Presbyterian Intercommunity Hospital, Whittier, CA

Ignacio Zarate, MD, Physician Advisor, Presbyterian Intercommunity Hospital, Whittier, CA

2:00 pm Basic ICD 10 Issues and How CDI Will Grow in Importance in 2014

E.G. “Nick” Ulmer, Jr., MD CPC, Vice President, Clinical Services and Medical Director for Case Management, Spartanburg Regional Health System, Spartanburg, SC

2:45 pm BREAK

3:00 pm ICD 10: How Documentation Challenges Can be Supported through the Physician Advisor’s Work

Jeffrey Farber, MD, MBA, Chief Medical Officer, Mount Sinai Care, LLC; Associate Professor, Brookdale Dept of Geriatrics and Palliative Medicine; Director, Appeals Management and Clinical Documentation Improvement Departments, Mount Sinai Medical Center, New York, NY

3:30pm Faculty Panel and Audience Q&A + Short Quiz

4:15 pm Preconference Adjournment

Getinformationonpast,current,andfutureRACSummit events right on your tablet or SmartPhone withtheRACSummitmobileapp.Enjoyacom-prehensiveINSIDERACSUMMITreportonRAC7inDecember2012,completewiththreeofthemostpopularvideopresentations.LookaheadtotheJuly22-24PA-URBootCampanduseyourdeviceonsitetotakenotes,seespeakerpresentationsandbios,email comments and suggestions, and more.

DOWNLOADTHERACSUMMITMOBILEAPP BEFOREJULyANDSTAyAHEADOFTHEGAME!

Or go to www.racsummit.com/app

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BOOTCAMPDAyIAFTERNOON— CONCURRENTREVIEW1:00 pm Overview and Expectations for the Afternoon

Day Egusquiza, President, AR Systems, Inc., Twin Falls, ID (Chair)

1:15 pm Step 2 — Concurrent and Daily Review: Optimizing Patient Flow with a Synchronized PA-UR Partnership

Angie Roberson, RN, BSN, CPUM, ACM, Director, Case Management and Transfer Center, Spartanburg Medical and Village Hospital, Spartanburg, SC

E.G. “Nick” Ulmer, Jr., MD CPC, Vice President, Clinical Services and Medical Director for Case Management, Spartanburg Regional Health System, Spartanburg, SC

2:00 pm Tracking and Trending Patterns and Using the PA for Ongoing Physician Education

Pamela Foster, APSW, MBA, ACM, Director, Care Coordination, Case Management and Social Services, Mayo Clinic Health System, Eau Claire, WI

2:30 pm BREAK

3:00 pm Presentation of Case Studies for Discussion — Are They Inpatient, Outpatient, or Observation? Hospital Representative from Each Lunch Table Assigned Physician Advisors

4:00 pm Day I Review: Pre-Bed Placement and Concurrent Review Faculty Panel and Audience Q&A + Short Quiz

Day Egusquiza, President, AR Systems, Inc., Twin Falls, ID (Moderator)

5:00 pm ADJOURN — Networking Reception in the Exhibit Hall Optional Networking Dinners

WEDNESDAy,JULy24,2013

BOOTCAMPDAyII— DENIALS,APPEALS,ANDADVOCACy7:00 am Registration Opens Networking Breakfast In the Exhibit Hall Optional Hosted Breakfast Table Topics

8:00 am Overview and Expectations for the Morning

Audience Response System Questions

Day Egusquiza, President, AR Systems, Inc., Twin Falls, ID (Chair)

8:15 am Step 3 — Denials: How to Incorporate the PA into a Process for Preventing a Pattern of Denials

Jeffrey E. Epstein, MD, Medical Director, Quality, Case Management and Resource Utilization, Stamford Hospital, Stamford, CT

Pamela Foster, APSW, MBA, ACM, Director, Care Coordination, Case Management and Social Services, Mayo Clinic Health System, Eau Claire, WI

Larry T. Hegland, MD, Chief Medical Officer, Ministry Saint Clare’s Hospital, The Diagnostic and Treatment Center, Weston, WI

9:15 am Step 4 — Appeals: Role of the PA with the Denials Team — Three Perspectives

Jeffrey Farber, MD, MBA, Chief Medical Officer, Mount Sinai Care, LLC; Associate Professor, Brookdale Dept of Geriatrics and Palliative Medicine; Director, Appeals Management and Clinical Documentation Improvement Departments, Mount Sinai Medical Center, New York, NY

Larry T. Hegland, MD, Chief Medical Officer, Ministry Saint Clare’s Hospital, The Diagnostic and Treatment Center, Weston, WI

Michael A. Salvatore, MD, FACP, Physician Advisor, Beebe Medical Center, Lewes, DE

10:15 am Networking Break and Prize Drawing in the Exhibit Hall

10:30 am Step 5: Congressional Grassroots Advocacy

Michael A. Salvatore, MD, FACP, Physician Advisor, Beebe Medical Center, Lewes, DE

11:00 am Day II Review: Appeals, Denials, and Advocacy Faculty Panel and Audience Q&A + Short Quiz What Did We Learn? What Are We Going to Do Back Home?

Ernie de los Santos, Consultant and Creator, The RAC Shadow, Los Angeles, CA (Moderator)

12:00 pm Adjourn

HOTEL INFORMATION/RESERVATIONSTheHyattRegencyO’HareistheofficialhotelforThePhysicianAdvisorandURTeamBootCamp.Aspecialgrouprateof$145.00single/doublepernight(plustax)hasbeenarrangedforBootCampAttendees.Tomakeyourhotelreservationsonlinepleasewww.RACSummit.comandclickontheTravel/Hoteltab.

youmayalsomakeareservationbycallingCentralReservationstollfreeat 888-421-1442or402-592-6464.PleaserefertoRACPhysicianAdvisorswhencalling.Reservations at the group rate will be accepted while rooms are available or until the cut-offdateofMonday, July 1, 2013.Afterthis,reservationswillbeacceptedonaspace-availablebasisattheprevailingrate.

Hyatt Regency O’Hare 9300BrynMawrAvenue,Rosemont,Illinois,USA60018•Tel:1-847-696-1234

REGARDING WEBCAST REGISTRATIONS

1. Individuals or groups may register for webcast access. Organizations may register for group access without presenting specific registrant names. In such instances the registering organization will be presented a series of user names and passwords to distribute to participants.

2. Each registrant will receive a user name and password for access. Registrants will be able to change their user names and passwords and manage their accounts.

3. Webcast registrants will enjoy six (6) months access from date of issuance of user name and password.

4. Only one user (per user name and password) may view or access archived confer-ence. It is not permissible to share user name and password with third parties. Should Webcast registrants choose to access post conference content via Flash Drive, this individual use limitation applies. It is not permissible to share alternative media with third parties.

5. User name and password use will be monitored to assure compliance.

6. Each webcast registration is subject to a “bandwidth” or capacity use cap of 5 gb per user per month. When this capacity use cap is hit, the registration lapses. Said registration will be again made available at the start of the next month so long as the registration period has not lapsed and is subject to the same capacity cap.

7. For webcast registrants there will be no refunds for cancellations. Please call the Conference Office at 800-503-0188 or 206-452-5495 for further information.

REGARDING ONSITE REGISTRATION, CANCELLATIONS AND SUBSTITUTIONS

1. For onsite group registrations, full registration and credit card information is re-quired for each registrant. List all members of groups registering concurrently on fax or scanned cover sheet.

2. For onsite registrants there will be no refunds for “no-shows” or for cancellations. You may send a substitute or switch to the online option. Please call the Conference Office at 800-503-0188 or 206-452-5495 for further information.

METHOD OF PAYMENT FOR TUITION

Make payment to Health Care Conference Administrators LLC by check, MasterCard, Visa or American Express. Credit card charges will be listed on your statement as payment to HealthCare (HC) Conf LLC. Checks or money orders should be made payable to Health Care Conference Administrators LLC. A $30 fee will be charged on any returned checks.

REGISTRATION OPTIONS

Registration may be made online or via mail, fax or scan.

You may register through either of the following:

• Online at www.RACSummit.com.

• Fax/Mail/Email using this printed registration form. Mail the completed form with payment to the Conference registrar at 22529 39th Ave. SE, Bothell, WA 98021, or fax the completed form to 206-319-5303, or scan and email the completed form to registration@hcconferences.com. Checks or money orders should be made payable to Health Care Conference Administrators LLC.

The following credit cards are accepted: American Express, Visa or MasterCard. Credit card charges will be listed on your statement as payment to HealthCare (HC) Conf LLC.

For registrants awaiting company check or money order, a credit card number must be given to hold registration. If payment is not received by seven days prior to the Conference, credit card payment will be processed.

TAX DEDUCTIBILITY

Expenses of training including tuition, travel, lodging and meals, incurred to maintain or improve skills in your profession may be tax deductible. Consult your tax advisor. Federal Tax ID: 91-1892021.

CANCELLATIONS/SUBSTITUTIONS

No refunds will be given for “no-shows” or for cancellations of either online or onsite registrations. You may send a substitute or transfer your onsite registration to an online registration. For more information, please call the Conference Office at 800-503-0188 or 206-452-5495.

INTELLECTUAL PROPERTY POLICY

Unauthorized sharing of Conference content via Webcast access through the shar-ing of user names and passwords or via alternative media (Flash Drive) through the sharing of said media is restricted by law and may subject the copyright infringer to

THE FOLLOWING REGISTRATION TERMS AND CONDITIONS APPLY HCCACHANGESNAMEANDBIFURCATESOPERATIONSHealth Care Conference Administrators, LLC (HCCA), www.eHCCA.com, after offering over 200 major healthcare and life sciences conferences over the past 15 years, is changing its name to Global Health Care, LLC (GHC, LLC) and will operate the following two separate lines of business “GHC, LLC Health Care” and “GHC, LLC Life Sciences.” GHC, LLC Health Care will offer healthcare policy and practice conferences. GHC, LLC Life Sciences will offer conferences principally focused on legal and compliance issues for pharmaceutical, medical device and biotechnology companies. New GHC, LLC Health Care and GHC, LLC Life Sciences web-sites will be launched shortly.

eXhiBiT ANd SPoNSoRShiP oPPoRTUNiTieS: Takeadvantageofthisuniqueopportunitytoexpandyourreach!TheSummitisattendedbyhighlyinfluentialandexperiencedprofessionals.Sponsorshipoffersyoustrategicpositioningasanindustryleader.Formoreinformationcall206-673-4815oremailexhibits@hcconferences.com.

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substantial civil damages. The Conference aggressively pursues copyright infringers. If a registrant needs the ability to share Conference content within his or her organiza-tion, multiple Conference registrations are available at discounted rates.

The Conference will pay a reward for information regarding unauthorized sharing of Conference content. The reward will be one quarter (25%) of any recovery result-ing from a copyright infringement (less legal fees and other expenses related to the recovery) up to a maximum reward payment of $25,000. The payment will be made to the individual or individuals who in the opinion of our legal counsel first provided the factual information, which was necessary for the recovery. If you have knowledge regarding the unauthorized Conference content sharing, contact the Conference registration office.

REGISTRATION BINDING AGREEMENTRegistration (whether online or by this form) constitutes a contract and all of these terms and conditions are binding on the parties. In particular, these terms and condi-tions shall apply in the case of any credit/debit card dispute.

GENERAL TERMS AND CONDITIONSProgram subject to cancellation or change. If the program is cancelled the only liability of the Conference will be to refund the registration fee paid. The Conference shall have no liability regarding travel or other costs. Registration form submitted via fax, mail, email or online constitutes binding agreement between the parties.

FOR FURTHER INFORMATIONCall 800-503-0188 (Continental US, Alaska and Hawaii only) or 206-452-5495, send e-mail to registration@hcconferences.com, or visit our website at www.RACSummit.com.

CONTINUING EDUCATION CREDITSPhysicians: This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medi-cal Education through the joint sponsorship of the Institute for the Advancement of Human Behavior (IAHB) and Health Care Conference Administrators, LLC.

Credit Designation Statement: The IAHB is accredited by the ACCME to provide continuing medical education for physicians. The IAHB designates this live activity for a maximum of 11.5 AMA PRA Category 1 Credit(s)TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses: Institute for Advancement of Human Behavior is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. This course is co-provided by IAHB and Health Care Conference Administrators, LLC. Maximum of 14.5 contact hours.

Physicians and Nurses — Satisfactory Completion Statement: Participants must complete an attendance/evaluation form in order to receive a certificate of completion/attendance. Chosen sessions must be attended in their entirety. Partial credit of individual sessions is not available.

Coders: This program has the prior approval of AAPC for up to 13.0 continuing education hours, depending upon session attendance. Certificates will be issued onsite. Online attendees must enroll in, complete, and successfully pass the final examination for the RAC Certificate Program for this conference in order to earn their CEUs. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

Other Attendees: Onsite attendees can request a Certificate of Attendance which they can file with other appropriate entities for credit, and webcast attendees can request a Webcast Certificate of Attendance on which they can certify the number of hours they watched and can file with appropriate entities for credit.

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HOW TO REGISTER: Fully complete the form below (one form per registrant, photocopies acceptable). Payment must accompany each registration (U.S. funds, payable to Health Care Conference Administrators, LLC).

ONLINE: Secure online registration at www.RACSummit.com.

FAX: 206-319-5303 (include credit card information with registration)

MAIL: Conference Office, 22529 39th Ave SE, Bothell, WA 98021

FOR REGISTRATION QUESTIONS:

PHONE: 800-503-0188 (Continental US, Alaska and Hawaii only) or

206-452-5495, Monday-Friday, 7 AM - 5 PM PST

E-MAIL: registration@hcconferences.com

PHySICIANADVISORANDURTEAMBOOTCAMP COMPLETE THE FOLLOWING. PLEASE PRINT CLEARLY:

NAME

SIGNATURE OF REGISTRANT - REQUIRED

JOB TITLE

ORGANIZATION

ADDRESS

CITY/STATE/ZIP

TELEPHONE

E-MAIL

❏ Special Needs (Dietary or Physical)

ONSITE CONFERENCE ATTENDANCEPRECONFERENCE (Optional, but required for the RAC Certificate Program):❏ Clinical Documentation Improvement, ICD10, and the UR-PA Partnership $ 395

CONFERENCE (Does not include Preconference):

Standard Rate: ❏ Through Friday, May 10, 2013* $1,195 ❏ Through Friday, June 14, 2013** $1,495 ❏ After Friday, June 14, 2013 $1,795

Hospital and Health System Rate: ❏ Through Friday, May 10, 2013* $ 695 ❏ Through Friday, June 14, 2013** $ 895 ❏ After Friday, June 14, 2013 $1,095

Conference — Critical Access Hospitals***: ❏ Flat Rate $ 595

RAC Certificate Program ❏ RAC Certificate Program $ 395

GROUP REGISTRATION DISCOUNT (Does not include Preconference):Three or more registrations submitted from the same organization at the same time receive the following discounted rates for conference registration only. To qualify, all registrations must be submitted simultaneously:

Standard Group Rate (For each registrant):❏ Through Friday, May 10, 2013* $ 795 ❏ Through Friday, June 14, 2013** $1,095 ❏ After Friday, June 14, 2013 $1,395

Hospital and Health System Group Rate (For each registrant):❏ Through Friday, May 10, 2013* $ 595 ❏ Through Friday, June 14, 2013** $ 795 ❏ After Friday, June 14, 2013 $ 995

CONFERENCE ELECTRONIC MEDIA:Onsite Attendees — Following the Summit, the video and presentations are made avail-able in the following formats. To take advantage of the discounted prices below, you must reserve media WITH your Summit registration:

❏ Flash Drive ($99 + $15 shipping) $ 114 ❏ 6 months’ access on Web $ 99Note that conference electronic media may be used by the individual purchaser only. Terms and Conditions apply (see page 6).

WEBCAST CONFERENCE ATTENDANCEAll webcast registrants are automatically registered for ALL online events — the preconference, the conference, and the RAC Certificate Program.

CONFERENCE (Includes the preconference, the complete boot camp, and the RAC Certificate Program):

Standard Rate: ❏ Through Friday, May 10, 2013* $ 795 ❏ Through Friday, June 14, 2013** $1,195 ❏ After Friday, June 14, 2013 $1,395

Hospital and Health System Rate: ❏ Through Friday, May 10, 2013* $ 595 ❏ Through Friday, June 14, 2013** $ 695 ❏ After Friday, June 14, 2013 $ 795

Conference — Critical Access Hospitals***: ❏ Flat Rate $ 395

GROUP REGISTRATION:Group registration offers the substantial volume discounts set forth below.

All webcast group registrants are enrolled in the preconference, conference and RAC Certificate Program.

Group registration offers the possibility of implementing a RAC online Certificate Program. Group registration permits the organizational knowledge coordinator either to share con-ference access with colleagues or to assign and track conference participation to employ-ees. Certificate of successful completion of online post conference examination evidences mastery of conference body of knowledge.

Conference Access: ❏ 5 or more $495 each ❏ 10 or more $395 each See INTELLECTUAL PROPERTY POLICY, page 6.

CONFERENCE ELECTRONIC MEDIA:Webcast attendees — Following the Summit, the video and presentations are made avail-able on a flash drive. To take advantage of the discounted price below, you must reserve media WITH your Summit registration:

❏ Flash Drive ($99 + $15 shipping) $ 114

(All webcast attendees automatically receive 6 months access on web.)

REGISTRATION BINDING AGREEMENTRegistration (whether online or by this form) constitutes a contract and all of these terms and conditions are binding on the parties. In particular, these terms and conditions shall apply in the case of any credit/debit card dispute. For online and onsite registrants there will be no refunds for “no-shows” or cancellations.

ACCOUNT #

EXPIRATION DATE SECURITY CODE

NAME OF CARDHOLDER

SIGNATURE OF CARDHOLDER

PAYMENT Discount Code:

TOTAL FOR ALL OPTIONS, ONSITE OR WEBCAST:Please enclose payment with your registration and return it to the Registrar at RAC Summit, 22529 39th Ave SE, Bothell, WA 98021, or fax your credit card payment to 206-319-5303.

You may also register online at www.RACSummit.com.

❏ Check/money order enclosed (payable to Health Care Conference Administrators LLC)

❏ Payment by credit card: ❏ American Express ❏ Visa ❏ MastercardIf a credit card number is being given to hold registration only until such time as a check is received it must be so noted. If payment is not received by seven days prior to the Summit, the credit card payment will be processed. Credit card charges will be listed on your statement as payment to HealthCare (HC) Conf LLC.

* This price reflects a discount for registration and payment received through Friday, May 10, 2013.** This price reflects a discount for registration and payment received through Friday, June 14, 2013.*** A Critical Access Hospital (CAH) is a rural acute care hospital of no more than 25 beds that meets certain geographic and staffing requirements and is certified by HHS to receive cost-based reimbursement from Medicare.

SPECIAL SUBSCRIPTION OFFER FOR BOTH ONSITE AND WEBCAST ATTENDEES:You can purchase an annual subscription to Predictive Modeling News for only $295 (regular rate $468) when ordered with your conference registration. ❏ Predictive Modeling News $ 295

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Best Practices from Pre-Admission to Appeal

The NATioNAl RAC SUMMiT

Physician Advisor & UR Team Boot Camp

www.RACSummit.com

A Hybrid Conference,

Internet Event & Training

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A Hybrid Conference,

Internet Event & Training

ToolSee page 3