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.

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.

Wednesday, October 9

This RACmonitor webcast discusses laws, regulations and other sources of regulatory requirements that govern Medicare Advantage plans and, importantly, when and how these plans can make changes to their contracts or operations that can have an impact on your facility.

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.

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.

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.

This exclusive RACmonitor webcast, led by David Glaser, provides you and your team useful legal arguments for responding to denials with proven strategies for how to best package your appeals, including how to write effective appeal letters and execute smart legal approaches.

Using actual examples of non-compliant issues, this webcast demonstrates the ongoing compliance challenges with HCCs in a risk-adjusted environment such as physician practices and Accountable Care Organizations (ACOs).

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.

This exclusive RACmonitor webcast addresses the perils of "simply removing FIMTM elements" from an IRFs documentation while providing success strategies for assuring accurate and compliant scoring.

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.

This webcast demonstrates how to strategize, track and trend claim denials in order to capture revenue, clean up claim submissions, improve efficiencies and prevent revenue leaks. It is estimated that claims denials are costing hospitals as much as 5 percent of their net revenue stream.

Learn how providers should assign the appropriate status to support medical necessity, optimize quality data and ensure appropriate hospital reimbursement in order to avoid claim denials by Medicare Part C auditors.

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.

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.

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.

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.

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.

Telehealth is here, although currently available only to rural healthcare market. But the future of telehealth is bright with the promise to increase revenue, marketing share and minimizing compliances risks as explained in this remarkable webcast that prepares you for the future.

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.

This exclusive RACmonitor webcast will discuss how policy changes to the Hospital Readmission Reduction Program (HRRP), expected to come from CMS, could impact your hospital's compliance, reimbursement and future participation in Medicare and Medicaid.

This webcast will demonstrate why you could be mistakenly refunding money to the government that you should actually be keeping for your facility. Some listeners have actually saved millions of dollars after listening healthcare attorney David Glaser.

This webcast will provide information on how Risk Adjustment Data Validation (RADV) audits —through the use of extrapolation of 200 charts—could cost your facility millions of dollars. Learn how to ward off auditors. Learn how to implement a compliance plan in order that protects your facility.

This webcast will focus on significant cases and investigations this past year. The focus will be lessons to be learned from government investigations, while also analyzing current OIG enforcement priorities. We will also discuss the 2019 Medicare Physician Fee Schedule.

New rules for therapy providers are effective Jan. 1, 2019. Without an understanding of the new changes impacting therapy services, providers are at high risk of committing documentation errors, leading to the submittal of claims with errors.

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.

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.

Utilizing real-world case examples that illustrate correct patient status, this webcast will provide a practical review of all the rules surrounding patient status and how to apply them on a daily basis at your facility whether you are a newcomer to case management or a seasoned professional.

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.

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.