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Live Webinar

90-minute live streaming program
  • September 24
  • 1:00 - 2:30 pm EST

Fundamentals of Medical Necessity Documentation

September 24

Understanding medical necessity and the documentation of it is important to both the provider and payer, and it is crucial that documentation is done correctly.

It is imperative in today’s environment that there is a clear understanding of what is meant by medical necessity. It is a crucial element for a health care provider to not only be paid and to be paid correctly, but to avoid an allegation of an overpayment should Medicare, or another payer, request supporting documentation for claims submitted. Everyone in the practice or clinic needs to be educated on how important a chief complaint is and what it means to have precise documentation. Coders and billers submitting claims as well as physicians and non-physician practitioners documenting services ordered or provided all need to have a good grasp of how payers make a medical necessity determination.

This information will review recent findings from CMS contractors on what they are looking for in verifying medical necessity. With so many different types of audits that can happen, we need to be armed and ready with knowledge on how to apply these findings. It is essential for proper reimbursement but also how to determine what documentation to submit when responding to a payer’s request for records.

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Why Lorman?

Over 32 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

Defining the Difference Between Medical Necessity and Medical Decision Making

How to Properly Document Clinical Indictors Versus Having a Problem List and Why This May Be an Audit Trigger

Discuss Tips on How to Avoid Denials and Rejects

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More Program Information

Why Lorman?

Over 32 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

Live Webinar Registration

  • ACHE 1.5
     
  • The American College of Healthcare Executives no longer pre-approves courses or organizations. Participants in this program wishing to have the continuing education hours applied toward ACHE Qualified Education credit should indicate their attendance when submitting an application to the American College of Healthcare Executives for advancement or recertification. ACHE Qualified Education credit must be related to healthcare management (i.e., it cannot be clinical, inspirational, or specific to the sponsoring organization). It can be earned through educational programs conducted or sponsored by any organization qualified to provide educational programming in healthcare management. Programs may be sponsored by ACHE, chapters or other qualified sources, whether the programming is face-to-face or distance offerings (webinars, online seminars, self-study courses, etc.).
     
  • AHIMA (Pending)
     
  • HFMA 1.5
     
  • This course is approved by HFMA for certification maintenance of continuous educational points and will equal 1.5 points of classroom instruction.
     

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

Who should attend?

This live webinar is designed for medical records directors, health information directors, coders, business managers, office managers, nurses, hospital administrators, billing managers, social workers, counselors, release of records professionals and compliance managers.

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Why Lorman?

Over 32 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

Rhonda Granja, B.S., CMC, CMA, CPC, CMOM

Rhonda Granja, B.S., CMC, CMA, CPC, CMOM

Rhonda Granja Consulting

  • Independent medical consultant and PMI faculty member
  • Speaker at the 2013-2015 PMI National Conference
  • Speaker at the 2014 AMBA National Conference
  • McVey Seminar leader
  • Panel speaker for The Coding Leader
  • Panel speaker at Compliance World
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Why Lorman?

Over 32 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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Product ID: 404360
Published 2019
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