Debra Mitchell – Insurance Coding And Billing For The Medical Office: 2019

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Debra Mitchell – Insurance Coding And Billing For The Medical Office: 2019
Ensuring Proper Payment for the Medical Office
In the majority of healthcare cases poor reimbursement, improper coding, and documentation is the culprit. While it is important to be paid for the services rendered by our providers, it is also important for the claims to be accurately coded. If we recognize that claims are a reflection of the patient, as well as the provider office, then the services and the diagnoses billed must be those which are documented in the medical record. Dealing with denied and rejected claims can be costly and frustrating! Not to mention ever-changing healthcare guidelines, laws, and codes.
This recording is designed to help you understand the claims process and avoid unnecessary back-end work, achieving optimal reimbursement, THE FIRST TIME, and success for your medical office. Develop a better understanding of how to effectively utilize CPT, ICD-10-CM, HCPCS II, and modifier codes to ensure proper payment. This course is a MUST for anyone who is involved in coding, billing, or reimbursement for the physician practice—including the physicians themselves!!

Maximize your reimbursement by emphasizing proper coding
Outline the 2019 changes to ICD-10-CM and CPT codes and how they affect your practice
Identify when to use attachments
Explain how to treat medical necessity denials
Assess what ICD-10-CM denials are most popular common
Discuss tips and techniques to obtain optimal and timely reimbursement
Examine bundling and how or when to unbundle codes
Illustrate proper submission of incident-to claims
Recognize what downcoding is and how to fight it and avoid it

FIRST LOOK AT 2019

The coding process
What to expect for 2019
The OIG Work Plan
Proper use of prolonged time codes – how this can help your practice, immediately

THE CODING PROCESS IN THE CHANGING HEALTHCARE ENVIRONMENT

2019 ICD-10-CM codes—a closer look
OIG work plan issues for physician billing
An overview of CPT changes
Modifiers and which ones can enhance reimbursement
Unraveling the complexities of Medicare, Medicaid, and Third Party Insurance

NAVIGATING THE INS AND OUTS OF THE CLAIMS SUBMISSION PROCESS

Know when documentation must be submitted with the claim
The elements of an incident-to claim
Recognize CCI edits (bundling) and understand how and when to unbundle

DOCUMENTATION, DOCUMENTATION

What to do if you have been downcoded
How to analyze and solve difficult billing problems
What to look for with a denial for medical necessity
Understand what to use from the documentation for an appeal or correction

EFFECTIVE TECHNIQUES FOR BETTER BILLING

How to avoid the most common errors
Know when to appeal and when to “write it off”
Understanding the importance of physician profiling
News from the CMS front that may impact your billing