Avoid Medical Necessity Audits for Pain Management
Tuesday, June 19
To avoid audits and possible take-backs, you need to understand requirements for coding and documenting pain management services in support of medical necessity for the services performed.
Avoid Medical Necessity Pitfalls When Documenting E&M Levels 4 and 5
Gain a better understanding of the documentation requirements for E&M services as well as the medical necessity implication of those services, especially in the Emergency Department setting. Learn how they work together to achieve a more accurate leveling of E&M services.
Total Knee Replacements: In or Out?
Mary Beth Pace of Trinity Health System and Jeffrey Pilger, MD at St. Elizabeth Healthcare in Edgewood, Kentucky lead this exclusive webcast and share their approach with you and your team for admitting TKR patients.
Cardiac Procedures Two-Part Series: Don't Leave Any Money on the Table
Cardiac procedures yield high rates of reimbursement. They’re also a target for auditing because that’s where the money is– big money! But to get all the reimbursement you deserve is tricky, challenging, and complex. That’s why RACmonitor is conducting this two-part series on steps your facility can take so you won’t leave money on the table–or have your reimbursement recouped.
OCR Audits and Enforcement Actions: Lessons Learned
Rita Bowen, a nationally recognized healthcare privacy expert, will report on the latest initiatives by the U.S. Department of Health and Human Services' (HHS) Office for Civil Rights (OCR), including updates on the HIPAA Audit Program, patient access guidance, and resolution agreements.
2018 Outpatient Therapy Rehab Updates: The Year of Living Dangerously
This webcast will provide concise statements and guidelines to assist outpatient therapy providers, regardless of venue, in understanding the applicable rules and regulations with CMS, as well as other large commercial payors who often replicate CMS rules for therapy policy.
Goodbye Total Knee Replacement. Hello Problems!
If you're looking for total knee replacement on the inpatient-only list, forget it. Turn off your computer and call your auditing department. Total knee replacement is gone. But your troubles are just starting.
OIG Work Plan Update: What's In. What's Out.
The good news: The OIG wants you to know what issues they’re looking at. The bad news: If during an investigation, they ask if you saw the plan and you say, “yes,” that signals you knew better. Say, “no,” and they’ll likely say you acted recklessly. It’s a Catch 22. Bottom line: You need to know what’s on their mind. And now you will, thanks to the upcoming OIG Work Plan Update webcast by healthcare attorney David Glaser.
Case Management to Finance: We're Better Together
Former medical director of case management and medical necessity reviewer, Dr. Ronald Hirsch, has created an innovative teaching method to help you and others in case management understand the frustrations of your finance staff.
Turmoil: Joint Replacements Headed to Outpatient Facilities
The Centers for Medicare & Medicaid Services (CMS) have proposed removing total knee replacement from the inpatient-only list as of January 1, 2018. And CMS has also asked for comments on removing total and partial hip replacement from the inpatient-only list, allowing all three surgeries to be performed in ambulatory surgery centers as of January 1, 2019.
Auditors Obsessing with Observation
In what promises to be a game-changer for you and providers, Dr. Hirsch will go into detail on the use of observation in both medical and surgical patients. And, he will also review the proper billing methods for observation.
New Medicare Appeals Process Could Help Your Facility Prevail at the ALJ
This presentation will benefit participants by providing an in-depth look at the changes to the Medicare appeals process set forth in the recent CMS Final Rule and key OMHA initiatives taking place at the ALJ appeal level. These Final Rule provisions and OMHA initiatives will have a significant impact on how you approach your Medicare appeals.
Mastering Medicare Advantage, Part II: Understanding Risk Adjustment and HCCs
Medicare uses a complex risk-adjustment process when paying Medicare Advantage Organizations (MAOs) for services provided to Medicare beneficiaries who enroll in a Medicare Advantage plan. Of particular interest is the Risk Adjustment Data Valuation (RADV) and associated Hierarchical Condition Categories (HCCs) as you will discover during Part II of this crucially important webcast by author, educator, and consultant Duane Abbey.