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Meeting Payer Document Requirements When Submitting Health Information

Make sure your documents are compliant when submitting health information in order to ensure maximized quality of care for your patients.

According to section 1862(a)(1)(A) of the Social Security Act, Medicare will not cover services that "are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member." Private payers and Medicare Advantage plans have their definitions of medical necessity. Not only do you want to make sure your documentation is compliant so that you are protected from false claims, you want to maximize revenue and improve the quality of care that your patients receive. This material will review how these go hand-in-hand and what your staff can do to help improve your practice as well.

Runtime: 89 minutes
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Why Lorman?

Over 33 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

Clinical Documentation Improvement

  • Compliance
  • Revenue
  • Quality of Care

Payer Guidelines

  • NCD/LMRP
  • NCCI Edits
  • ABN and Private Pay Patients

Putting It in Practice

  • Front Desk
  • Ancillary Staff
  • Providers
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Why Lorman?

Over 33 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 June 19, 2020.

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

  • AHIMA 1.5 including Clinical Data Management 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 does NOT qualify, nor meet the National Standard for NASBA accreditation.

MP3 Download

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

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More Program Information

Why Lorman?

Over 33 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

Merrilee Severino, CPC, CMMP

Merrilee Severino, CPC, CMMP

CLA, LLC

  • Senior consultant with CLA, LLC
  • More than 20 years of experience in billing and practice management
  • Spoken for The Coding Institute, Physicians Practice magazine, PAHCOM, AAPC, POMAA, BC-Advantage Magazine; and has been interviewed in many publications including the book Paper Kills 2.0, forward by Newt Gingrich and Tom Daschle, available at healthtransformation.net
  • Recognized as one of this nation’s health care industry experts and contributes to Billing Coding Advantage Magazine as part of their editorial board
  • Experience as a certified coder that with a former role as an Independent Coding Officer for client under integrity agreement with the OIG
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Why Lorman?

Over 33 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: 407050
Published 2020
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