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Medicare Changes for 2018

Make sure your organization is ready for any changes that may arise within the realm of Medicare billing and coding.

This topic will focus on changes to the Medicare program in 2018. Without proper clinical documentation and coding many services from hospitals and physicians will be denied. Compliance programs will be reviewed to include internal auditing and education of staff. The number one denial in today's health care operations is medical necessity. Accomplished coders must pay attention to the detail of diagnostic coding to make sure payment is produced. Utilizing the OIG's yearly Work Plan will help facilities audit their own deficiencies and improve their compliance with governmental auditing programs. This past year there have been several entities auditing for CMS, (Centers for Medicare and Medicaid Services) to confront fraud and abuse. This topic will explain how these entities are working together to recoup payments from providers and Medicare administrative contractors.

Runtime: 85 minutes
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Why Lorman?

Over 31 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

Agenda

CMS Updates for 2018

  • RAC: Recovery Audit Contractors
  • CERT: Comprehensive Error Rate Testing
  • EGlobal Tech: Comparative Billing Reports
  • CMS Target Probe and Educate: Medical Review Strategy Program
  • OIG: Workplan 2018

Recovery Audit Contractors

  • High Risk Vulnerabilities for Physicians
  • Statement of Work
  • Updates on Status of Recovery Audit Contractors and Prepayment Reviews

CERT Program

  • No Documentation
  • Insufficient Documentation
  • Medical Necessity
  • Incorrect Coding

EGlobal Tech Comparative Billing Reports

  • Educating Providers About Medicare's Coverage, Coding, and Billing Rules
  • Reviewing Claims Before They Are Paid to Assure Compliance With Coverage, Coding, and Billing Rules
  • Reviewing Claims After They Are Paid to Identify and Collect Overpayments Made to Providers

CMS Target Probe and Educate

  • How TPE Tracks Improper Payments
  • Data Analysis and Billing Patterns
  • Education of Providers

OIG Workplan

  • How to Review Workplan
  • Tying Internal Auditing to OIG's Workplan
  • Entities That Audit
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More Program Information

Why Lorman?

Over 31 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

Credits

OnDemand Webinar

This course was last revised on December 21, 2017.

Call 1-866-352-9540 for further credit information.

  • AHIMA 1.5 including External Forces 1.5
     
  • This program has been approved for 1.5 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting prior approval from AHIMA does not constitute endorsement of the program content or its program sponsor.
     

This program format does NOT qualify, nor meet the National Standard for NASBA accreditation.

Audio & Reference Manual

This program format does NOT qualify, nor meet the National Standard for NASBA accreditation.

MP3 Download

This program format does NOT qualify, nor meet the National Standard for NASBA accreditation.

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More Program Information

Why Lorman?

Over 31 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

Faculty

Cheryl House, RMC, CHI

CCH Medical Consultants

  • Partner with CCH Medical Consultants, a consulting and billing management facility
  • Certified Evaluation and Management Coder through AAPC
  • Certified health care instructor, working in consulting and billing management for more than 30 years
  • Nationally known speaker on health care topics such as CMS regulation, specialty coding/billing and health care trends in managed care
  • Knowledgeable billing and managed care consultant as well as an excellent seminar instructor
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Why Lorman?

Over 31 years and 1.4 million customers worth of experience providing continuing education. Our passion is providing you world-class training to help you succeed in business and as a professional.

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  • State Specific Credit Tracker
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* For audio recordings you only pay shipping

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Product ID: 400439
Published 2017
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