Revenue Cycle Basics for Reimbursement Specialists Part-I and II

Event Information
Product Format
Prerecorded Event
Presenter(s)
Barbara J. Cobuzzi, MBA, CPC, CENTC, COC, CPC-P, CPC-I, CPCO, AAPC Fellow
Length
180 minutes
Product Description

Get a Closer Look into an Effective Appeal Process, Micro-Level Management & Common Compliance Issues with Barbara Coubuzzi

Revenue cycle management (RCM) is the process that manages claims processing, payment and revenue generation. However, it’s not as simple as it sounds —there are many bumps in the road for the healthcare provider to encounter when it comes to collection. You need to stay on top of private payer rules through an organized process of information gathering, billing and address any issues, allowing for a steady stream of revenue. The process includes keeping track of claims in the system, making sure payments are collected and addressing denied claims, which can cause up to 90 percent of missed revenue opportunity.

Session Highlights:

  • What affects the success of the billing process?
  • What bumps in the road does the practice encounter when it comes to collection and what can be done to eliminate these bumps?
  • Why not paying heed to payer rules can cause practices irrecoverable losses in revenue, and can even result in an overpayment refund request.
  • Insurance verification: When, how and what to verify—in order of efficiency.
  • Know the difference between reimbursement rules from payer to payer and increase your profitability.
  • Insights on coding and billing of post-operative complications for Medicare patients vs. non-Medìcare patients.
  • Efficient workflow and process in revenue cycle management (RCM).
  • Documentation expectations—Seven general principles of documentation.
  • Who or what is CCI Edits? Understanding the CCI Edits’ Manuals.
  • Insights on approaches to denial management.
  • What to look for in a software for robust and immediate reporting? Understand the tools to understand the rules.
  • Is it an appeal or correction? What is the difference between Claim Appeal and Correction?
  • How to use payer appeal forms effectively and what to do when an appeal is not successful?
  • Discussion on Micro-level Management and an effective Appeals Process.
  • Overview of Level II appeal objectives.
  • What you need to know about Clinical Attachments and the importance of Timely Filling Attachments.
  • Redetermination decisions and reconsiderations by QIC

Who should attend?

  • Physicians
  • Office Managers / Administrators
  • Billers
  • Coders

 

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About Our Speaker

Barbara J. Cobuzzi - Healthcare Compliance Training Expert

Barbara J. Cobuzzi is owns CRN Healthcare Solutions where provides value added provider consulting services.  She holds a BS in Industrial Engineering from Rensselaer Polytechnic Institute and an MBA from New York University.  She holds certifications from the AAPC as a CPC (certified physician coder), COC (certified hospital outpatient coder), CPC-P (certified payer coder) a CPC-I (certified coding instructor) and a CPCO (certified professional compliance officer).  She also...   More Info
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