Super Smart Strategies for Appealing Ridiculous DRG Denials
Thursday, April 29
During this webcast you will learn behind-the-scenes information that will help you to autopsy the reason why the claims were denied which, in turn, will empower CDI initiatives at your facility to effectively appeal ridiculous DRG denials.
Condition Code 44: Learn How to Get it Right
Wednesday, May 5
Led by physician advisor Dr. Juliet Ugarte Hopkins, this webcast explains why case management and utilization review have incorrectly applied Condition Code 44 for nearly 20 years and demonstrates the correct and compliant way this controversial code should be implemented.
Unlocking the Riddle of Medical Necessity
This webcast clearly defines medical necessity and how that concept is applied to procedures, admissions, and sites of service, while clearing up the most common areas of confusion.
TPE Audits: Learn to be a Smarter Responder
This webcast discusses the implications of Targeted Probe and Educate (TPE) audits in the context of other audits in the overall audit-enforcement landscape, plus how you can reduce your level of risk if your organization is targeted.
Acute Heart Failure: Successful Denial Appeal Strategies
DRG and clinical validation auditors are exploiting the confusion surrounding what is, and what isn't, acute heart failure. From Dr. Beth Wolf, you'll learn the most common reasons for heart failure claim denials and how to formulate an effective appeal, supported by key clinical indicators.
Acute Heart Failure: Coding, CDI and Appeal Strategies Set
This two-part webcast combo from ICD10monitor and RACmonitor, presented by Dr. Beth Wolf, covers must-know clinical aspects of acute heart failure, plus deep dives into the validation of DRGs and clinical documentation, as well as strategies for claim denial appeals.
Readmissions Prevention: Learn Compliant Strategies to Avoid Penalties
This webcast analyzes readmissions from several different perspectives including the finances of prevention for Medicare and commercial patients, the various payer programs dealing with readmissions, the right and wrong way to avoid readmissions, and how to know whether your facility is doing it right
COVID-19 Provider Relief Funds: How to Avoid Audits
The myriad of federal and state rules and regulations attached to the PRF are explained by healthcare attorney Knicole Emanuel who also reveals important exceptions to those rules and how to mitigate risks and possible audits.
ABNs and HINNs: Stay in Compliance During COVID-19
This webcast provides solutions to common struggles that case managers and utilization specialists face when trying to identify the appropriate patient notice (HINN and ABN) and how they can remain compliant with CMS regulations during the PHE and beyond.
COVID-19: Clearing up Regulatory Confusion
Healthcare attorney David Glaser untangles rules and waivers associated with telemedicine, Stark, licensure and practical legal issues surrounding the wearing of face masks and vaccine requirements.
Outpatient Therapy: 2021 Strategies for Survival
Nancy Beckley will help equip your organization to survive a planned 9% reduction in 2021 reimbursements for outpatient therapy services, coupled with a resumption of CMS audits. You’ll take away a clear understanding of the latest Medicare payment rules and how to consistently apply them.
Learn Strategies to Stop AKI Revenue Leaks
This RACmonitor educational webcast describes specific denial rationales often presented by the payer and offers corresponding appeal strategies while addressing how a proactive approach of performing second level reviews of AKI/ATN denials can mitigate further denials.
Payer Audits: Know Your Rights and How to Appeal
Building and sustaining a well-maintained compliance program creates strong defense strategies to combat the non-specific denials or lack of clinical judgment by payers and their contracted auditors.
OIG Workplan: What You Don't Know is a Compliance Risk
The OIG Workplan describes areas of intended investigation by the OIG, including specific COVID-19 regulations. This webcast describes those areas in order for providers to align, prioritize and focus their compliance efforts.
Learn Secrets to Avoid COVID-19 Claim Denials
Dr. John K. Hall identifies a wide range of risks for COVID-19 related claim denials that are generally not considered by revenue cycle, utilization management and case management teams that make providers "easy targets" for payers to deny claims or make appeals more difficult to achieve.
CMS 2021 Rule Update for Care Management and Utilization Review
The 2021 IPPS final rule, the 2021 proposed rules for OPPS and the Medicare Physician Fee Schedule are reviewed during this webcast so that your facility can prepare for these new regulations. Failure to comply leads to compliance, revenue and patient dissatisfaction risks.
Surgery: Know the Rules for Status, Location and Medical Necessity
Dr. Ronald Hirsch takes a deep dive into surgery status, medical necessity and site-of-service rules, which differ significantly among the various payers. By consistently applying these rules, you can prevent claim denials that eat away at vital revenue from surgical procedures.