Overcome Common Payer Audit Challenges

Common Audit Triggers That Make Physicians Vulnerable

Event Information
Product Format
Prerecorded Event
Presenter(s)
Dorothy D. Steed, CCS, CDIP, COC, CPCO, CPUM, CPUR, CPHM, CPMA, ACS-OP, CCS-P, RCC, RMC, CEMC, CPC-I, CFPC, PCS, FCS,
Length
60 Minutes
Product Description

2013 has seen Payer audits on the rise, including Medicare, Medicaid and Private Payers. This trend is already promising a high number of similar audits in 2014 as well. The sophistication of claims processing edits, provider profiling, documentation standards and questionable billing patterns all contribute to identification of unusual billing and reimbursements.  When documentation does not support the codes billed, providers are often liable for recovery of funds and possible penalties.  

Join us for this On Demand webinar tomorrow Thu, Aug 29, 2013. This webinar can be accessed anytime of the day once registered.

Here are a few topics covered in the session:

  • Diagnosis & procedure triggers
  • Payer system edits & Documentation gaps
  • Incorrect place of service & unlikely units
  • Comparison of hospital, physician and sedation reporting
  • Questionable Evaluation and Management levels
  • Look at the claim from the payer prospective.  Does it make sense as submitted?
  • Does the E &M code seem reasonable based on diagnosis code(s) reported?
  • Minimal coding variations & Unrealistic number of units
  • Watch using unspecified codes & Failure to state time
  • Schedule periodic in-house audits using random samples on each provider
  • Track areas of weakness and implement educational feedback targeting improvement processes
  • Consider outside audit at least annually
  • Identify correct primary payer & Secondary payers
  • Implement quality measures in your billing/coding process
  • Maintain a low profile.  Do not engage in creative billing practices
  • And much more…

 Who should attend? Billers, revenue cycle, physicians, claims follow up, precertification staff, managers, C-Level Exec, Compliance Officers

Order Below or Call 1-866-458-2965 Today

You can also order through:
Phone

1-866-458-2965

Fax

1-919-287-2643

About Our Speaker

Dorothy D. Steed - Medical Coding and Billing Expert

Dorothy D. Steed, CCS, CDIP, COC, CPCO, CPUM, CPUR, CPHM, CPMA, ACS-OP, CCS-P, RCC, RMC, CEMC, CPC-I, CFPC, PCS, FCS, CPAR, is an independent healthcare consultant and educator in Atlanta. She was a Medicare specialist for a large hospital system and a physician coding audit supervisor for another hospital system, with 40 years of experience in healthcare. Additionally, she is an instructor at a state technical college in...   More Info
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