| Time | Topic | Presentation Description |
9:00am-10:00am |
"Preparing for and Defending Against Payor Audits: Tips and Strategies to Increase Success" |
Jenna Godlewski will offer tools to prevent and defend payor audits, covering audits by commercial and managed care payors, as well as state and federal prosecutors. It includes website links identifying current audit focuses, tips for organizing and submitting documentation, strategies for analysis and defense using various resources, and proactive compliance measures to avoid audits. |
10:15am-11:15am |
"CMS Tightens Medicare Enrollment and Revocation Rules in 2024" |
Jenna Godlewski will focus on key changes Medicare enrollment rules effective January 1, 2024, that significantly expand CMS authority to deny and revoke a provider’s enrollment. Some topics covered include increased time added to reapplication bars if false or misleading information is provided on a Medicare enrollment, the new “stay of enrollment” sanction, reduced timeframe to trigger deactivation for non-billing, a new requirement for change of location reporting, fingerprint-based background checks for high-risk providers seeking revalidation and increased restrictions on providers who order, certify and prescribe. |
11:30am-12:30pm |
"Risk Adjustment Coding - Specificity in the Patient Condition" |
Devyn Berube will provide a general overview of the risk adjustment payment model and the specificity required for coding a patient’s medical condition(s). Multiple risk adjustment payment models exist. This presentation will focus primarily on the CMS-HCC model for Part C (Medicare Advantage) payers and the coder’s role in translating the provider’s documentation into code. |
12:45pm-1:45pm |
"The Fundamentals of Denials Management" | Devyn Berube will present the fundamentals of denials management, including a look at common denials, root causes, and how to develop effective strategies to mitigate lost revenue. |
1:45pm-2:00pm |
Wrap-Up and Questions |
*Time zone is Eastern Standard Time (EST)
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