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Avoid Refunding Your Medicare Claims Based on E&M Guidelines

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Gain a better understanding of the legal significance of E&M guidelines, and learn how to protect your revenue by not refunding your Medicare claims based on evaluation and management (E&M) guidelines.


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Price: $229.00

Product Code: AR030118


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Are you a clinic or hospital performing a coding review? Are you refunding Medicare for claims that did not meet evaluation and management (E&M) guidelines? Register now to attend this live webcast and learn why that isn't necessarily the best way to lower your organization's risk.

The E&M guidelines are just that, guidelines. They're not the law. While there is tremendous value in following them, they are not a requirement. The fact that the documentation for a particular Medicare encounter does not satisfy the guidelines does not mean that you must make a refund on the claim. In fact, a refund may be counterproductive. This exclusive RACmonitor live webcast will explain the legal significance of the guidelines. Many well-intentioned documentation reviews actually increase the risk you will face an overpayment or False Claims Act case.

Learning Objectives:

From this exclusive webcast, you will come to understand…

  • Why "if it isn't written, it wasn't done" may be good risk management advice, but is not the law.
  • How the use of the words like "over-coded" and "overpayment" are often misleading and harmful to your organization.
  • Learn common review myths, including the claim that medical decision making always controls the level of service, or that you must refund when a chart is unsigned.
  • When a refund is necessary and when a problem may be addressed through education without any repayment.
  • The proper wording for a refund letter.