Managing Medicare Denied Claims in a SNF

Event Information
Product Format
Prerecorded Event
Caroline Mullin, MS, OTR/L
60 Minutes
Product Description

Understand the Goals of Various Medical Reviews and Learn Tips to Effectively Respond to Medical Record Requests

The goal of medical review is to determine whether the services are reasonable and necessary, delivered in the appropriate setting, and coded correctly, based on appropriate documentation.  This program by expert speaker Caroline Mullin will enable healthcare providers to provide quality healthcare through an understanding of the Medicare Reimbursement system in a skilled nursing facility.

Caroline will begin this session by discussing the goals of Medical Review and various Medical Review programs including Recovery Audit Contractor (RAC) and Carrier (Medicare Administrative Contractor or Fiscal Intermediary) Medical Review programs. Going further, she will divulge keys to responding to a medical record request as well as appeal tips and strategies.

The conference will cover:

  • Medicare Coverage and Documentation
  • Overview of Changes to Chapter 8 Medicare Benefit Policy Manual
  • Overview of Jimmo v. Sebelius Settlement related to Skilled Rehabilitation
  • Medicare Compliance
  • Medical Record Review Preparedness
  • The Appeal Process

Session Highlights:

  • Learn a systematic approach to the Appeal Process
  • Learn how the Jimmo v. Sebelius Settlement is related to Skilled Rehabilitation
  • Learn how to proactively avoid Medical Record Review
  • Learn how to achieve Medicare Compliance
  • Identify Potential Audit Triggers

Who should attend? CEOs, CFOs, Administrators, Nursing Management, Nursing Staff, Therapy Management, Occupational Therapists, Physical Therapists, Speech Pathologists and Business Office Managers

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About Our Speaker

Caroline Mullin - Home Health Coding Expert

Caroline Mullin, MS OTR/L is a Corporate Consultant and the Denial Manager for Harmony Healthcare International (HHI), an industry leader in Long-Term Care Consulting. 

HHI is a premier Long-Term Care Consulting firm specializing in Reimbursement and Compliance.  In her role,

Caroline has extensive knowledge in the areas of MDS 3.0, RUG-IV, Documentation, Therapy Program Development, state-specific Medicaid Case Mix and Denials Management. Academically

Caroline...   More Info
More Events By The Speaker

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Dear Valued Customers


We regret to announce that ProEdTech LLC and all its affiliate brands will cease operations on April 1, 2019.


We are no longer able to fulfill online orders. We will fullfill all DVD and book orders already placed.


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