Use Patient Status to Stop Claim Denials
Learn how you should assign the appropriate status to support medical necessity, optimize quality data and ensure appropriate hospital reimbursement in order to avoid claim denials by commercial payers.
Learn How to Prepare for Observation Audits by the RACs
Thursday, September 26
This webcast will demonstrate to you and your team how to distinguish inpatients from outpatients with observation services, while helping you to understand the time-sensitivity of observation services and what steps to take in preparation for observation audits.
Dying and Death: What Case Management and Utilization Review Need to Know
Wednesday, October 23
Determining the proper status for patients presenting at the end of life or those who have elected hospice rather than curative care can be confusing for case management and utilization review of those patients. This RACmonitor webcast mitigates patient status confusion.
How to Obtain Post-Acute Authorizations from Managed Medicare Plans
Learn how to leverage Managed Medicare insurers who are denying authorizations for inpatients requiring post-acute care. A more recent challenge is obtaining authorizations for long term acute care (LTAC), acute rehabilitation and subacute rehabilitation (SAR) which will be explained in this webcast.
CMS 2020 Rule Update for Care Management and Utilization Review
The 2020 IPPS Final Rule, the 2020 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 that become effective Oct. 1, 2019. Failure to comply leads to compliance, revenue and patient dissatisfaction risks.
New Rules from CMS about the RACs Will Impact You
You may think that you are adequately appealing your adverse decisions. But if you know the issues that even CMS believes exist regarding the RACs, you may be more successful in your appeals as you will discover during this webcast led by healthcare attorney Knicole Emanuel.
The Patient Notification Forms: Getting the Right One Right the First Time
This exclusive RACmonitor webcast demonstrates how and when to use the right patient notification form when communicating a patient's status. Using the wrong form or even the right form with incomplete information is a red flag to auditors who typically side with patients in case involving disputes.
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.
TPE Targets: Learn Sensible Solutions to Avoid Audits
This webcast will include a review of the targeted probe and educate (TPE) process. During this webcast you will receive a timetable of important deadlines to be met if you are being audited. You will also receive tips for medical record preparation. And you will also learn about current audit targets.
2019 Survival Guide for Off-Campus Provider-Based Clinics
This webcast will explain the direction of provider-based clinics in terms of reimbursement as well as how payments will be made for off-campus excepted clinics. Failure to understand these changes could result in your facility being a target for auditing and facing the loss of reimbursement.
New RAC Auditing on IRFs Puts Revenue at Risk
The RACs are back with a vengeance. Having received the green light in September from the CMS to conduct complex medical reviews, they are going after inpatient rehabilitation facilities (IRF) with an assault on Medicare claims.
Avoid Denials: Learn How to Crosswalk from Acute Care to SNF
What's the difference between an acute care stay or a SNF stay? And when is it safe to make an appropriate discharge? From this exclusive RACmonitor webcast you'll know how to get the patient to the right place for the right amount of time while avoiding an unsafe discharge or a denied claim.