Medicare

Medicare and private payers all recognize medical necessity as a deciding factor for claims payment and it is important that all practices know the rules. We will discuss:Applying the rules to your patient encountersMedical decision making and medical necessityImportance of diagnosis codingCoverage determination policiesUsing an electronic health record (EHR)How to respond to requests for recordsHow to appeal if you disagree with decisions from outside reviewers

This webinar has been designed to provide guidance to you when you receive a denial (specifically, should you file a new claim or request an appeal). This webinar will address the most common reason/remark codes associated with each denial, as well as descriptions for each. Also, with each denial, an explanation will be provided to assist you with resolving the denials and avoiding them in the future. The webinar also aims to help in reducing and/or eliminating calls to the provider contact center (PCC) by providing you with the proper route to take to correctly bill your claims.