Agenda

If you are one of those who believe NCCI stands for “No Coder Can Interpret,” you won’t want to miss this session! You’ll leave understanding how procedure-to-procedure edits work, how they are developed, and when it’s appropriate to override and appeal when they lead to claim denials. Also learn about Medically Unlikely Edits (MUEs) and add-on code edits and how they impact your claims, as well as when and how to use NCCI-related modifiers, including the X-modifiers.

There’s nobody better than a former fraud cop to tell you what the feds are looking for and how to stay off their radar! A former federal healthcare fraud prosecutor turned healthcare defense attorney updates you on enforcement trends, key vulnerabilities, and best practices to avoid a costly government investigation or audit.

Your payer contracts are the basis of your practice’s revenue, but finding the agreements, addenda, and rates and then inventorying this information can be daunting. Attend this session and learn how to push through the first steps toward getting your payer contracts in order. Learn how to gather your current contracts and rates; determine which contracts to tackle first; create a timeline for each negotiation; and draft and send an effective Notice to Renegotiate.

You’ve identified what payers’ rates need the most improvement and how to approach them, and you’ve gotten a payer to the table to negotiate … only to hear them say, “What did you have in mind?” What do you do? Don’t blow the opportunity to achieve your improvement goals by using less-than-adequate data or analysis! This session walks you through how to create an offer and evaluate a counteroffer based on tried and true methods, leaving you confident that both the aggregate improvement and the code-specific impact are figures you and your physicians can live with.

The goal of this session is to create a connected and streamlined revenue process that allows easier identification of identifying leaks in the revenue stream. Speaker Doris Branker will also cover critical elements in a billing/collections process/procedure that should be in place to ensure practices run like well-oiled revenue generating machines. Also addressed are vital skills that should be included in your revenue cycle department.

Federal and state auditors and investigators change their enforcement plans regularly. How about you? How long has it been since you’ve updated your compliance plan? If you don’t have millions of dollars to spend on fraud settlements, you need to make sure you have an airtight compliance program. This session uses recent government actions against pain management practices to alert you to the latest compliance risks for practices, clinicians, and coders, and gives you up-to-the-minute tips to make sure you have a compliance plan that protects everyone from those risks. You’ll also receive guidance for getting physicians to buy into compliance and back up the compliance officer in the event of a dispute.