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.
Turmoil: Joint Replacements Headed to Outpatient Facilities
Tuesday, September 19
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.
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.
Mastering Medicare Advantage: An Important 2-Part Webcast Series
Medicare Advantage is like sitting down and confronting a bowl of goulash—a steamy brew of meat, vegetables and broth. You really don't know what you're getting into until it's too late. Medicare Advantage is a brewing stew of compliance issues.
The MOON: Lessons Learned: An Important Case Study
The MOON is a new requirement that just went into effect on March 8, 2017. It is a requirement that many sites are struggling to deliver. This webcast, featuring lessons learned from Trinity Health, will help you identify what could work in your own organization. Sharing processes and policies means that you don't have to reinvent the wheel.
Warning: The RACs Are Back. New Contracts. New Rules.
The Recovery Audit Contracts—the RACs—are ready to start auditing your claims. While some processes will resemble previous audits, there are important changes to the new rules that warrant review, analysis, and understanding.