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Meeting Payer Document Requirements When Submitting Health Information

Make sure your documents are compliant when submitting health information 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, but you also 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.

60 minutes
Course Exam
Certificate of Completion
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Why Lorman?

Over 37 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 37 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 Course

This course was last revised on July 12, 2023.

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

No Credit Available

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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Why Lorman?

Over 37 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, CRC, CMMP, CPCS

Merrilee Severino, CPC, CRC, CMMP, CPCS

Your Business Medic

  • Owner of Your Business Medic
  • Former senior consultant with CLA, LLC
  • More than 30 years of experience in credentialing, billing, and practice management
  • Has 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 healthcare industry experts and contributes to Billing Coding Advantage magazine as part of their editorial board
  • Experience as a certified coder with a former role as an independent coding officer for a client under integrity agreement with the OIG
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Why Lorman?

Over 37 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.

All of your training, right here at Lorman

All of your training, right here at Lorman.

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Additional benefits include:

  • State Specific Credit Tracker
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Questions? Call 877-296-2169 to speak with a real person.

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Product ID: 410791
Published 2023
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Available in Multiple Formats

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