Wednesday, March 17

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.

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.

Tuesday, March 23

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.

Thursday, April 1

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.

This webcast explains how to save your facility hundreds of thousands of dollars in potential repayment and fines by correctly following CMS requirements for medical device credits and managing patient accounts when devices are billed.

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

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.

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.

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.

Compliance expert Michael Calahan has been scrutinizing the payer and regulatory landscape and is prepared to share his findings of likely 2021 compliance targets. He’ll also lay out best practices that will help you prepare for or, better yet, avoid audits.

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.

In this RACmonitor webcast, Dr. Ronald Hirsch examines the inpatient-only list for 2021 and presents a logical process to evaluate all surgeries to determine the correct status and to support that with proper documentation.

This webcast demonstrates how to improve physician documentation to reflect the level of care that determines the patient status—inpatient versus observation. Knowing the difference can avoid claim denials and revenue loss.

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.

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.

Across the country, IRFs were blindsided by the COVID-19 pandemic. Angela Phillips, one of the nation's leading IRF authorities, will share her appraisal of the various responses, as well as how to prepare for the next public health emergency.

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.

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.

SNFs face hundreds of COVID regulatory exceptions that will be eliminated upon the expiration of the PHE. Audits will follow.

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.

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.

David Glaser provides hospitals and clinics answers to important pricing questions, as well as an overview of the new price transparency rule that will apply to hospitals on January 1, 2021.

Juliet Ugarte Hopkins will ensure you fully comprehend the nuanced facts of patient status assignment and precisely what is needed to compliantly carry out a Condition Code 44.

This webcast exposes how some payers have manipulated admitting criteria by MCG and InterQual to deny claims for not meeting their arbitrary definition of medical necessity and provides a strategy to fight back.

This webcast will walk equip you with strategies for accurate charge capture and billing for COVID-19 related services and procedures, as well as plan to prepare for and better mitigate the risk of perceived fraudulent billing.

This webcast reveals how auditors are using incorrect and arbitrary data to deny claims for acute respiratory failure and how to prevent and appeal those denials successfully.

Attorney Knicole Emanuel explores the likely targets of post-pandemic audits and provides healthcare providers with tools and knowledge to defend themselves.

Dr. Hirsch provides the essential elements your hospital needs to achieve compliance with the new CMS prior authorization program and to ensure proper medical necessity documentation for these procedures, thereby protecting reimbursement.

This webcast explains how to mitigate compliance risks and revenue loss by using the correct patient status codes as identified in the Post-Acute Care Transfer (PACT) rule.

During this webcast, Nancy Beckley provides outpatient therapy providers with the facts, updates and resources to understand e-visits and telehealth temporary codes under the 1135 waivers while remaining compliant with other 2020 regulatory changes.