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xSpeaker: Jeffrey Restuccio

Date: December Wednesday 14th

Time:01:00 PM EST | 10:00 AM PST

Duration: 90 Minutes

Product Code: 700628

Level: Beginner

Overview

This webinar is the result of over 15 years of auditing medical charts and teaching coding and billing to providers, coders, billers and management. Reporting the proper E & M codes and level is critical to any medical practice. Most coding certification exams do not test or cover the Medicare auditing guidelines. In addition, the guidelines are generic whereas actual auditing has many shades of gray and interpretation.

Why Should You Attend

The focus of Ritecode is to protect the providers and interests of any organization. Our audits are very detailed as we tackle numerous issues not typically addressed. In addition, we teach the 50 percent rule which means that charts should be audited based on the premise that if 50% or more auditors will rule against the doctor, changes should be made.

There are many types of audits and auditors: OIG, Medicare, RAC, state board and legal. Each one can have a slightly different focus. It is common to have audits by two auditors or firms that disagree. The goal is to lower the percentage to ten-percent or lower (in other words, 90% of auditors should agree with the findings).

Most practice managers and providers are under the impression that all audits and auditors are the same. That is not the case and this webinar will explain the differences in detail.

Areas Covered in this Webinar

  • 12 steps to winning carrier denial appeals
  • Most common reasons that claims are denied and specific examples
  • Medical necessity, modifiers, LCDs, HCPCS codes and all the fundamental concepts
  • Carrier-specific rules, manual and hierarchy and concept of payment guidelines
  • Appeal tips and tricks you won’t learn anywhere else

Learning Objectives

  • Get dozens of ideas and tips for bringing back reimbursement from denied claims
  • Get an action plan with examples on how to win carrier appeals every time
  • Hear real-life examples, sound advice and get ready to fight for dollars rightfully due to your practice
  • NCCI edits, modifiers, medical necessity and local coverage determinations will be discussed as well as more advanced concepts delving into carrier-specific rules and creating a carrier-specific manual

Who Will Benefit

  • Billing Managers
  • Billers
  • Coders
  • Coding Managers
  • Providers

Speaker Profile

Jeff has two coding certifications: the Academy of Professional Coders (AAPC) certified professional coder for physician (outpatient) reimbursement and the AAPC certified professional coder for hospital (inpatient) reimbursement. Jeff has been a certified coder since 1999.

Jeff has the unique combination of twenty years of experience, Medical Coding Certifications (CPC & COC), training experience (medical coding and billing) a strong background in databases and Information Systems, and an MBA in Finance.

Jeff is an experienced educator and auditor, having conducted hundreds of training courses, worldwide on CPT and ICD-10 coding and billing, auditing and compliance. He has audited over 10,000 medical records.

Jeff has worked for numerous hospitals and medical clinics. Clients include Baptist and Methodist hospitals (in Memphis TN), Hospital Management Associates, Medicare, the VA and the DOD.

Source Link: https://complianceglobal.us/product/700628/Jeffrey-Restuccio/the-art-of-the-audit/Live

 

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