Case Management to Finance: We're Better Together
Former medical director of case management and medical necessity reviewer, Dr. Ronald Hirsch, has created an innovative teaching method to help you and others in case management understand the frustrations of your finance staff.
Turmoil: Joint Replacements Headed to Outpatient Facilities
The Centers for Medicare & Medicaid Services (CMS) have proposed removing total knee replacement from the inpatient-only list as of January 1, 2018. And CMS has also asked for comments on removing total and partial hip replacement from the inpatient-only list, allowing all three surgeries to be performed in ambulatory surgery centers as of January 1, 2019.
Auditors Obsessing with Observation
In what promises to be a game-changer for you and providers, Dr. Hirsch will go into detail on the use of observation in both medical and surgical patients. And, he will also review the proper billing methods for observation.
New Medicare Appeals Process Could Help Your Facility Prevail at the ALJ
This presentation will benefit participants by providing an in-depth look at the changes to the Medicare appeals process set forth in the recent CMS Final Rule and key OMHA initiatives taking place at the ALJ appeal level. These Final Rule provisions and OMHA initiatives will have a significant impact on how you approach your Medicare appeals.
Mastering Medicare Advantage, Part II: Understanding Risk Adjustment and HCCs
Medicare uses a complex risk-adjustment process when paying Medicare Advantage Organizations (MAOs) for services provided to Medicare beneficiaries who enroll in a Medicare Advantage plan. Of particular interest is the Risk Adjustment Data Valuation (RADV) and associated Hierarchical Condition Categories (HCCs) as you will discover during Part II of this crucially important webcast by author, educator, and consultant Duane Abbey.
How to Write a Proposed Decision to the ALJ and Get Paid Sooner Than Later
With the backlog at the Office of Medicare Hearings and Appeals, more than a few ALJs are asking appellants to submit proposed decisions. Will you be ready and able to give the ALJ something they can actually use? Now, thanks to this exclusive webcast and former ALJ and decision writer, Bob Soltis, you'll be able to write a proposed decision to include with your Request for Hearing.
Mastering Medicare Advantage, Part I: Improve Reimbursement, Claim Adjudication and Appeals
Medicare Advantage programs are becoming more and more popular. Understanding the differences between Medicare Advantage and traditional Medicare can translate into better reimbursement and less cost in filing and tracking claim adjudication and payment as you will discover during Part I of this crucially important webcast by author, educator, and consultant Duane Abbey.