2008 CareFlite ECU Conference Registration Form - 04_22_08print

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2008 CareFlite ECU Conference Registration Form - 04_22_08print Powered By Docstoc
					                   2008 CareFlite Emergency Care Update Conference
             June 23 & 24, 2008 ♥ 8am ‘til 5pm ♥ Arlington Convention Center

Free & Open to all
First Responders &
ER/ICU Providers
But Please Register…
Continuing Education
Credits Offered*…

CLINICAL FOCUS: The CareFlite Emergency Care Update planning committee has assembled speakers from across our
region and state as well as nationally recognized presenters who are willing to share their experience and skills at our
2008 conference on June 23rd & 24th at the Convention Center in Arlington, Texas. The CareFlite Emergency Care
Update Conference focus is clinical and designed to provide a deeper understanding for paramedics and nurses of the
management and care of the critically ill and injured patient. The educational presentations consist of adult, pediatric,
and obstetrical. Presentation of case studies, or topics geared to enhance the professional image of the healthcare
professional are also presented. Earn Continuing Education Credits.* More information is available on the next page
and at www.careflite.org .

also feature a special all day documentation and billing track on Monday June 23rd only. This separate track will be
presented by Steve Wirth Esq. and Maggie Adams of Page, Wolfberg and Wirth, a nationally recognized law firm
specializing in EMS compliance. This track is an excellent opportunity for clinical managers, billers and ambulance
managers to get comprehensive, refresher training on the many billing, documentation and reimbursement issues
facing ground ambulance providers in 2008. More information on this track is provided below. While the overall
conference is free, attendance at this separate track costs $200 for the first attendee and $100 for each additional
attendee. More info on this track and separate registration form inside.

2008 GREAT FIRST RESPONDER AWARDS: Presentation of the 2008 Great First Responders Awards will follow the
conclusion of the first day of the Conference at 5pm on Monday June 23rd. For information on how to nominate
someone for a 2008 Great First Responder Award visit www.careflite.org.
                 2008 CareFlite Emergency Care Update Conference
           June 23 & 24, 2008 ♥ 8am ‘til 5pm ♥ Arlington Convention Center

                              CNE Hours & Tx DSHS CE’s Available

                                 Initial List of Speakers & Topics
                    (Additional nationally recognized speakers will be added once committed)

Speaker:                       Topic:

Jason Dush, LP                 OB Trauma Cases Study; My patients pinned and pregnant!
                               EMS and Nursing, Tension vs Teamwork

Kris Powell, RN                Through the Ages; Generational Diversity in the Workplace
                               High Dose Steroids in Spinal Cord Injuries; The Rise and Stall
                               of a Standard of Care

Carlton Rojas, RN              Pre-Hospital Management of the Traumatic Brain Injury

Kenneth Navarro, LP            The ABC’s of Cardiac Arrest; Is the “B” Necessary?
                               Bad Bugs! Antibiotic Resistant Bacteria
                               Impedance Threshold Device; Improving Survival
                               from Cardiac Arrest?

Sheila Elliott, EMT-P          Blue Babies

Nanci Negal, RN                Burn Care; Beyond the Rule of Nines
                               Therapeutic Hypothermia after Cardiac Arrest;
                               Get Ready to Chill Your Patients

Karen Yates, RN                I Want a New Drug;
                               Part One – Street Drugs
                               Part Two – Club & Designer Drugs

Ray Fowler, MD                 Difficult ECG Rhythms in EMS

* CareFlite is an approved provider of continuing nursing education by The Texas Nurses
Association, an accredited provider by the American Nurses Credentialing Center’s Commission on
Accreditation. This activity meets Type 1 criteria for mandatory continuing education requirement
towards re-licensure as established by the Texas Board of Nursing.
                                      Registration Form
                     2008 CareFlite Emergency Care Update Conference
               June 23 & 24, 2008 ♥ 8am ‘til 5pm ♥ Arlington Convention Center

                       The conference is free, but you must pre-register.
            I plan to attend the 2008 CareFlite ECU Conference. Please check as appropriate.
                            □ June 23rd only □ June 24th only □ Both Days
Your Name: _____________________________________

Your Title:      _____________________________________

Affiliation:     _____________________________________

Address:         _____________________________________


License #        _____________________________________

Phone #          _____________________________________

Email:           _____________________________________

Please print this form and submit by fax to (972) 602-7182
                                   Registration Form
                 Billing, Documentation & Reimbursement Track Only
                             2008 CareFlite ECU Conference
              June 23, 2008 ♥ 8am ‘til 5pm ♥ Arlington Convention Center

□ Check here to register for the Billing, Documentation & Reimbursement Track to be offered on
  Monday, June 23rd only. The Conference is free except for this separate check. Please fill in the
  credit card information below to guarantee your place in this excellent course.

Your Name: _____________________________________

Your Title:   _____________________________________

Company:      _____________________________________

Address:      _____________________________________


License #     _____________________________________ (if applicable)

Phone #       _____________________________________

Email:        _____________________________________

Add’l Attendees: ______________________________________________

                 (Attach additional sheet if necessary)

Credit Card □ Visa □ Master Card      Card # _______________________________

Name on Card: ________________________________________________

Expiration Date: ____________________________

I authorize the following total charge to this credit card $_____________
□$200 Initial Attendee □ $100 For Each Additional Attendee

Signature for Credit Card

Please print this form and submit by fax to (972) 602-7182
                           Billing, Documentation & Reimbursement Track
This track is an excellent opportunity for clinical managers and billing personnel of ground ambulance operators to
get the latest and greatest on documentation and billing compliance issues.

Course Subjects:           Write it Right! EMS Documentation Skills Workshop (4 hours – Steve Wirth)
                           The Liability of Apathy: It’s All About Meeting Expectations (1-1.5 hours – Steve Wirth)
                           EMS LAW: Top 10 – 2008 and Beyond (1-1.5 hours – Steve Wirth)
                           Liability in the Trenches: EMS Case Law Studies (1-1.5 hours – Steve Wirth)
                           Reimbursement Update (1hour – Maggie Adams)
                           Getting the Most From All Payors (1.25 hours – Maggie Adams)
                           Non-emergency Ambulance Service – Billing Challenges (1.25 hours – Maggie Adams)

Schedule:          Steve Wirth                                Maggie Adams
                   8am – Noon Write it Right                  8-9am & 1-2pm Reimbursement Update
                   1 – 2:15pm The Liability of Apathy         9:15 – 10:30am & 2:15 – 3:30pm Getting the Most
                   2:30 – 3:15pm EMS LAW: Top 10              10:45am - Noon & 3:45 – 5:00pm
                   3:30 – 4:45pm Liability in the Trenches     Non-Emergency Amb Service – Billing Challenges

Steve Wirth Esq. has 30 years of experience as an EMT, paramedic, flight paramedic, EMS instructor, fire officer, and
EMS administrator. He is currently one of the three members of the Commission on Accreditation of Ambulance
Services (CAAS), the national ambulance service accrediting body. Steve is a frequently sought-after speaker at
regional, state and national conferences on a variety of EMS, fire service and public safety subjects. He has authored
numerous articles on a variety of EMS management, risk management, corporate compliance and workplace law
topics. He is a contributing writer for the Journal of Emergency Medical Services (JEMS) and The EMS Insider. Steve co-
authored the highly acclaimed Ambulance Service Guide to HIPAA Compliance (now in its third edition); The Ambulance
Service HIPAA Privacy and Security Video; Better Billing: The Ambulance Service Model Compliance Plan; and The
Ambulance Service Model Personnel Handbook. Steve graduated cum laude from Duquesne University School of Law
and was a member of the school’s national trial advocacy competition team. In addition to his law degree, Steve has a
Masters Degree in Health Services Administration from Gannon University in Erie, Penn. He remains in touch with
patient care and field provider issues as an active EMT and nationally certified firefighter with the Hampden Township
Volunteer Fire Company, where he serves as the medical officer. Steve is also a life member of the Nippenose Valley
Vol. Fire Co. near Jersey Shore, Penn., where he started his public safety career as a junior firefighter and later served
as Lieutenant and then Deputy Fire Chief. He also serves on the Executive Boards of the Pennsylvania Fire and
Emergency Services Institute, and the Initial Life Support Foundation (formerly known as the AED Instructor

Maggie Adams is a Senior Consultant and Reimbursement Specialist at PWW. She has considerable             experience
in assisting ambulance services and EMS organizations across the country in organizing and obtaining maximum
efficiency from their billing operations, as well as in managed care payment, contracting and appeals issues. Prior to
joining PWW, Maggie was the founder and president of EMS Financial Services, Inc., a company dedicated to resolving
billing and collections problems for medical transportation providers. Her firm successfully collected thousands of
ambulance bills for volunteer, hospital-based, for-profit, and non-profit ambulance services and offered consulting
services for ambulance providers on accounts receivable management and reimbursement issues.

About Page, Wolfberg & Wirth LLC: At PWW, our attorneys have years of hands-on experience as EMS field providers,
managers and administrators, plus unparalleled expertise in a full range of legal matters affecting the ambulance
industry. We know EMS from the inside out. PWW presentations bring our expertise to life, on the topics that EMS
professionals care about most. See for yourself why PWW attorneys and consultants are among the most sought-
after presenters at conferences nationwide.

Coming From Out of Town?
Here is a list of hotels near the Arlington Convention Center:

        Hilton Hotel Arlington              www.hilton.com                    (817) 640-3322
        Arlington Courtyard Marriott        www.marriott.com                  (817) 277-2774
        Ameri Suites                        www.amerisuites.com               (817) 649-7676
        Country Inn-Arlington               www.countryinns.com               (817) 261-8900
        La Quinta: Arlington                www.lq.com                        (800) 531-5900
        Wingate Inns - Arlington            www.wingateinns.com               (817) 640-8686
        Springhill Suites-Six Flags         www.marriott.com                  (817) 860-2737
        Homestead-Arlington                 www.homesteadhotels.com           (817) 633-7588
        Sheraton Arlington Hotel            www.starwoodhotels.com            (817) 261-8200
                                            (adjacent to Convention Center)
        Days Inn - Arlington                www.daysinn.com                   (817) 261-8444
        Sanford House Bed & Breakfast       www.thesanfordhouse.com           (877) 205-4914

                                                      Want to bring your family for the weekend prior
                                                      to the conference? Call (800) 342-4305 or visit
                                                      www.arlington.org for complete information
                                                      on all the attractions and family fun in Arlington,