Understanding Medicare Self-Denial and Rebilling
Every MCR-participating facility utilizing the 2-Midnight rule has to be familiar with CMS-guided self-deny decision process resulting in subsequent rebilling. Recent and increased 2-midnight audits by the QIOs mean your facility could be at risk if you are an outlier.
Appealing Clinical Validation Denials: A Team Effort
This webcast will review point-by-point how to optimize your organization's appeals process. From initial understanding of appeal processes available via contractual agreements to denial review and assessment and finally to effective appeal, you'll come away with a step-by-step map ready to implement.
Total Knee Arthroplasty: The Status Controversy Continues
Learn to determine the correct patient status for patients undergoing total knee arthroplasty. Failure to assign the correct TKA patient status could trigger potential RAC audits, claim denials and takebacks impacting facilities and physician practices as you will learn during this RACmonitor webcast.
How to Challenge Unreasonable Positions by Medicare Advantage Plans
This RACmonitor webcast walks you through some of the rules you are obligated to follow from private insurance companies, especially in light of rules governing traditional Medicare. From this webcast you will know when to push back, and strategies for making this relationship less frustrating.
New Strategies for Documenting to Support Quality
To thrive under CMS quality-based pay-for-performance program adjustments in FY2019, it is increasingly important for you to understand clinical documentation practices to ensure those practices support accurate reporting of quality metrics which are so essential in the reporting of public data.
Biggest RACs Changes Are Here: Learn to Avoid Denied Claims
This webcast will review the biggest and latest changes to RAC audits. And there are significant new changes to their efforts to deny claims and recoup reimbursement. And, after having returned $214 million to the Medicare program in 2016, they're looking for more money—no doubt yours—during 2019.