Providers are faced with a nightmare landscape of audit and compliance risks in 2020. Between the MACs, MICs, RACs, UPICs, SIUs and other auditing entities, providers' exposure is almost unlimited, and with commercial and governmental payers motivated by profits and maintaining contracts, the question is not "if" you will be audited, but "when" it will happen. Moreover, providers are not only subject to audits from these entities, but they must also grapple with commercial insurance companies who are constantly pushing the goal line further back, thus changing the rules in their favor in the "coding and billing" game.
The government and commercial payers establish their "hit-lists" and "audit targets" based on successes from previous years and based on areas where they believe providers are vulnerable to criticism on their documentation resulting in an ability to determine services were not "Medically Necessary" and to demand refunds.
The number of audits, recoupments, and suspensions from participation with payers is already skyrocketing. And that is why RACmonitor has asked compliance expert Sean Weiss to conduct an important webcast that will show providers how to mitigate exposure to audits and gain the upper hand. Sean will also provide the action steps you must take to ensure you're compliant with coverage policies and stay 2 steps ahead of the payers. Don't be the next on the list, be prepared!
Why This is Relevant:
With the MACs, MICs, RACs, and UPICs, plus other auditing entities, your exposure is almost unlimited. Ensuring compliance is critical to not only to survive but to thrive in an environment laden with pitfalls and traps.
- Discover the target areas frequently used by governmental and private payers
- Learn how to establish a payer policy manual to aid in documentation and code selection requirements to substantiate services billed
- Learn pre-emptive steps you can take to mitigate risks
- Learn how to establish "medical necessity" tools you can implement to ensure compliance and to assist in the performance of internal reviews.
Who Should Attend:
Auditors, coders, compliance officers, managers, and providers.