Tuesday, November 3

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.

Wednesday, November 11

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.

Wednesday, November 18

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.

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.

Learn how to effectively overturn clinical validation denials for malnutrition and encephalopathy by overpowering faulty payer and third-party review rationale.

Understand the rules and policy, while mitigating common misunderstandings surrounding the billing for incident-to and split-shared services.

This webcast provides a strategic approach to optimize the prevention and management of complex DRG denials, while mitigating immediate revenue loss and protecting the future financial health of your facility.

Michael Calahan explains what hospitals need to know about the "Two-Midnight Rule," how this rule impacts observation services, and how these services are informed by the federal expectations around short-stay admissions and the physician orders for inpatient admissions.

This webcast explains —in plain English— the Medicare regulation and the manual provisions for billing incident-to and split-shared services while clearing up common misunderstandings surrounding these services.

This webcast describes what you should do to mitigate exposure in dealing with the governmental and commercials payers who establish their own "hit lists" and "audit targets."

Basic concepts and compliant billing of observation services are reviewed during this webcast, including proper use of condition code 44, when observation is used and not used after surgery, and how to avoid excess hours denials.

Discharge Planning Conditions of Participation, the CMS Final Rule, is sure to be a game-changer for most hospitals and health systems. Learn how one of America's largest health systems is complying with the tough requirements mandated by CMS.

New and significant "must-know" changes to the Medicare program, including the correct reporting of credits for implantable medical devices and managing patient accounts when such devices are billed, are discussed in this webcast led by Michael Calahan.

There are significant therapy changes for 2020, and providers must be prepared to navigate the changes prior to Jan. 1, 2020. During this RACmonitor webcast, nationally recognized outpatient therapy compliance expert Nancy Beckley reviews new codes for outpatient therapy.

For this RACmonitor webcast, we've secured Dr. Ronald Hirsch, one of our most trusted and popular presenters, to help you sort out key changes in the 2020 Hospital Outpatient Prospective Payment System (OPPS) Final Rule, so you're equipped to seize opportunity and minimize your compliance risks in 2020.

This RACmonitor webcast, led by healthcare attorney David Glaser, provides practical tips that will lower the chance your organization will face a government investigation.