Coding and Healthcare Fraud

Event Information
Product Format
Prerecorded Event
Jonnie Massey, CPC, CPC-P, CPC-I, CPMA
60 Minutes
Product Description

Medical Coding Fraud Costs Everyone – Don’t Let This Be You!

Incorrect or inaccurate medical coding can lead to more than claim denials, payment delays and recoupment. Correct coding is critical in establishing and maintaining a high functioning practice. Ensuring claims are coded accurately and submitted appropriately will pay dividends. This session by Jonnie Massey will focus primarily on CPT® codes, with additional information presented on ICD-9 coding challenges. Areas discussed will be up-coding or billing for a higher level of service that was performed, un-bundling or splitting out charges that could be reported using one code and under-documented services or billing for services that are not sufficiently documented for payment. Incorrectly coded services can be costly. A detailed discussion about the cost of incorrectly coded claims will be conducted and you will see how coding issues are frequently tied to Health Care Fraud, Abuse and Waste. Arm yourself in these difficult financial times with every tool you can to maintain a healthy revenue cycle.

Coding examples will be provided including some of the most problematic areas of coding. Attendees will leave the session armed with a better understanding of how critical coding accuracy is, and how the lack of correct coding has the potential to be viewed as misrepresented services.  Real life scenarios will be discussed in order to demonstrate the link between coding and health care fraud.

Session Highlights:

  • Importance and impact of correct coding
  • Where and when coding starts
  • Tips for understanding problematic codes and proper usage
  • What to do if incorrect coding is discovered
  • Fix it and code on!

Who should attend? Medical professional including but not limited to: Front office staff, back office staff, office managers, coders, billing personnel, collection personnel and providers – all specialties.

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About Our Speaker

Jonnie Massey - Healthcare Compliance Expert

Jonnie Massey CPC, CPC-P, CPC-I, CPMA has more than 27 years in the health care industry primarily for working for health plans. Her experience includes leadership and supervisory roles in addition to being responsible for a start-up Special Investigations Unit. She is an Accredited Health Care Fraud Investigator and also holds four (4) certified coding credentials from AAPC including the Payer, Auditor and Instructor certifications in addition to the Certified...   More Info
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