Medical Necessity - The Collaborative Partnership Approach

CD & Manual
  386154TMX $199.00 USD Add to Cart
Credit Details
 85 Min. Audio MP3 - No shipping cost
   386154POD $199.00 USD Add to Cart
Credit Details
What is a Podcast?

Benefits

Hospitals constantly struggle with reducing financial exposure due to noncompliance with medical necessity in the ordering and performing of diagnostic tests on both the inpatient and outpatient business environment. Current hospital business processes and medical staff mind-sets do not lend themselves and promote financial efficiencies in the performance and reimbursement of diagnostic tests, particularly radiology procedures. This teleconference will help you understand and appreciate how the evolution of medical necessity in the last two years can be capitalized upon in educating and promoting the concept of medical necessity as a collaborative partnership between physician and hospital. Failing to promote a synergistic approach to medical necessity from the hospital and physician perspective will undoubtedly lead to increased financial exposure significantly impacting hospital financial health and operations, as well as the physician's ability to maintain a financially viable business of the practice of medicine.


Agenda

Historic Perspective of Medical Necessity
  • Local Coverage Determinations and National Coverage Determinations
  • Antagonistic and Punitive Approach
  • Perpetuation of the Treadmill
Evolution of Medical Necessity
  • Developments of the Last Two Years
  • Medical Necessity – Physician Initiative vs. Hospital Initiative
  • Impact of Medical Necessity Upon Physician's Practice of Medicine
  • Elements of Medical Necessity Beyond Diagnostic Tests
Medical Necessity – A Synergistic Approach
  • Necessity of Collaboration Between Physician and Hospital
  • Vested Financial Interest of Both Parties
  • Evolving Business Financial Model – Financial Repercussions
Strategies to Promote Medical Necessity Synergies and Partnerships – Physician and Hospital
  • Best Strategies to Promote Physician Education and Buy-In From Physicians
  • Proven Tips to Overcome Physician Resistance and Reluctance
  • Practical Advice and Guidance on Building and Expanding Upon Achieved Successes to Maintain Cultural Paradigm Shifts in Medical Necessity Mindset

Faculty

Glenn Krauss, RHIA, CCS, CCS-P, CPUR, FCS, PCS, C-CDIS, CCDS, Independent Consultant

Glenn Krauss, RHIA, CCS, CCS-P, CPUR, FCS, PCS, C-CDIS, CCDS
  • Independent revenue cycle consultant
  • Expertise in ICD-9 and CPT coding auditing and education; billing reviews; chargemaster reviews; development and implementation of clinical documentation improvement programs; and education of physicians on concepts and intricacies of evaluation and management code assignment and the establishment and support of medical necessity for services rendered and billed through complete, effective documentation that is specific, accurate and detailed
  • Conducts regular seminars on clinical documentation improvement, medical necessity and financial/regulatory updates directly impacting the physician’s business of the practice of medicine
  • Member of American Health Information Management Association and the Healthcare Financial Management Association
  • Advisory board member, Association for Clinical Documentation Improvement Specialists
  • Regularly contribute articles to health care related business periodicals and newsletters on various related topics
  • B.B.A. degree, Hofstra University
  • Certificate in health information management, University of Washington, Seattle
  • Contact him at Glennkrauss@earthlink.net or 603-303-3337





These Materials are Designed For

Medical records directors, coding and billing professionals, directors of health information, medical facility administrators, insurance professionals, attorneys and other health care providers

CD & Manual - CD Set with bound 26 page manual
Podcast - 85 Minute MP3 with 26 page electronic manual - Immediate Access and No Shipping Cost