Agenda

Sometime the only way forward is out. For more and more practices, medical billing and collections are no longer an inside job. When you look at your billing and collections, are you dissatisfied with what you’re getting out of them, but unable to think of a way to make them more productive? Maybe the answer is to make a big change—to outsource your internal operations or demand more from an outside vendor. Speaker Doris Branker covers how to calculate whether outsourcing is a profitable move and how to get vendors to raise their targets for you without also raising their price.

CMS has made changes to its HCC tables and changed its encounter vs. RAPS mix for Medicare Advantage (MA). What does that mean for MA and private payers’ risk adjustment, and how does it affect your coding, billing, and payment? This session covers what to look for in provider documentation of chronic conditions and their treatment. You’ll learn what errors or omissions might adversely affect reimbursement or draw auditor attention, and how to encourage providers to clearly document not only their services but also the details necessary for risk adjustment purposes.

Coding companies work around the globe, sometimes at outrageously low rates. But can you be sure these companies will do the job correctly? From a compliance standpoint what questions need to be asked and answered prior to entering a contract? What if there are coding errors resulting in overpayments? How is this handled? Who is responsible? What is their commitment to quality assurance? What happens if there’s an impasse between the coding company and you, the client? As a compliance officer for a coding company, the speaker is intimately familiar with the balancing the challenges of compliant outsourced coding and client satisfaction.

Sure, your audit skills are spot on and you’re seen as the expert, but are you clearly communicating your thoughts when writing the report, or are you causing confusion and/or agitation for the provider? What are the best approaches to writing concise and diplomatic explanations that influence behavior? How do you turn your audit report into an educational instrument instead of a punitive or insulting piece of work? Our speaker, a veteran auditor, report writer and technical review expert, will talk you through scenarios that show you how.