In today’s healthcare environment, there is increasing pressure to cut costs and it is more important than ever to find ways to quickly and efficiently identify coding and billing issues. Amidst a time of shrinking operating margins and heightened scrutiny by federal healthcare contractors, providers are seeking to focus on the benefits of technology-driven internal auditing. Learn more about how to stay ahead of payer audits by mining your own data from your claims to identify areas of risk and proactively fix potential issues.
Did you miss Evaluation and Management Updates 2023: Training and Q&A presented by Panacea Healthcare Solutions’ Director of Coding & Documentation Services, Becky Jacobsen, CCS-P, CPC, CPEDC, CBCS, MBS, CEMC, BSN? Look no further. Our experts have developed a set of customized resources to aid professionals as they put the guidelines into practice.
1st Talk Compliance features guest Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., on the topic “DMEPOS – In Compliance with CMS.” Rachel joins our host Catherine Short to discuss special payment rules associated with durable medical equipment, prosthetics, orthotics and supplies. DMEPOS products must meet quality standards, suppliers need to be accepted by Medicare to participate, similar to providers, and are subject to fraud, waste, and abuse laws. This episode will provide an overview of participation and quality requirements, relay the latest compliance and requirements updates, and discuss the consequences of non-compliance, as well as submitting false and fraudulent claims.
An audio version from the live event: It’s important to understand how the application of the 2023 E&M codes impacts reimbursement. Inaccurate coding and inefficient documentation practices can result in a decline in revenue and increase the likelihood of downstream inaccuracies of patient data. Join Panacea Healthcare Solutions’ Director of Coding & Documentation Services, Becky Jacobsen, CCS-P, CPC, CPEDC, CBCS, MBS, CEMC, BSN, and Executive Vice President of Coding & Documentation, Kathy Pride, RHIT, CPC, CCS-P, for a complimentary 90-minute training where they will review the 2023 E&M documentation guidelines and requirements and provide examples on how to improve your internal documentation processes to ensure appropriate reimbursement and avoid compliance issues.
Executive Vice President of Coding & Documentation, Kathy Pride, RHIT, CPC, CCS-P, and Director of Coding & Documentation Services, Becky Jacobson, CCS-P, CPC, CPEDC, CBCS, MBS, CEMC, BSN at Panacea Healthcare Solutions will lead the complementary training and Q&A session, “Evaluation and Management Updates 2023: Training and Q&A” on February 7, 1-2:45 pm ET
Many practitioner audits fall short of best practices. The modern healthcare environment and complex goals for compliance require time, expertise, and attention to detail. Ideally, audits occur at regular intervals and identify incidents and patterns of potential billing and coding risk. There are also some surprising upsides of professional audits that include greater visibility of under-coding.
Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX presents this very timely and fascinating subject for us. A former nurse was charged, criminally prosecuted, and in March 2022, convicted of gross neglect of an impaired adult and negligent homicide for a 2017 fatal drug error. The purpose is to inform participants of a myriad of items so that facilities can evaluate and implement appropriate safeguards, train nurses and other staff, and take corrective actions before an adverse patient outcome occurs. What happened here is preventable and nurses should not flee the profession, especially because of the compassion shown by the judge.
1st Talk Compliance features guest Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX, on the topic of “HIPAA and Beyond: Documentation Retention & Legal Holds.” This episode addresses laws that are relevant to healthcare industry participants, as well as compliance suggestions, and steps to take when either a legal hold or a preservation request arrives.
Catherine Short speaks with Rachel V. Rose, JD, MBA, principal with Rachel V. Rose – Attorney at Law, P.L.L.C., Houston, TX, on the topic of “The No Surprises Act – What You Need to Know.” Effective January 1, 2022, the No Surprises Act has implications for patients, providers, and insurance companies alike. The impetus behind the legislation, as well as the regulations, is to prevent patients from receiving bills for certain services that were performed or delivered by providers out of their plan’s network. The scope is limited and providers and plans alike need to take steps to understand the appeal process when a payment or claim is challenged. The purpose of this episode is to provide a brief overview of the evolution of the United States’ healthcare system and its relevance to the No Surprises Act. From there, the No Surprises Act and regulations will be explained, along with the appeal process. Finally, compliance tips will round out the show.
Melody W. Mulaik, MSHS, FAHRA, CRA, RCC, RCC-IR, CPC, CPC-H is the President of Revenue Cycle Coding Strategies LLC and our esteemed presenter. 2022 was scheduled to be the the official implementation date for AUC/CDS implementation but the 2022 Proposed Rule threw everyone a little curve ball. While a delay will occur it does not change the direction of the program or the need to prepare and test. As providers continue to either prepare their own practices or bridge the gap with imaging facilities, it is important that everyone be on the same page throughout the CMS implementation and remaining testing period.