Debra Mitchell – Insurance Coding and Billing for the Medical Office: 2019DescriptionEnsuring Proper Payment for the Medical OfficeIn 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!!HandoutsManual – Insurance Coding and Billing for the Medical Office (5.89 MB) 158 Pages Available after PurchaseOutlineFIRST LOOK AT 2019The coding processWhat to expect for 2019The OIG Work PlanProper use of prolonged time codes – how this can help your practice, immediatelyTHE CODING PROCESS IN THE CHANGING HEALTHCARE ENVIRONMENT2019 ICD-10-CM codes—a closer lookOIG work plan issues for physician billingAn overview of CPT changesModifiers and which ones can enhance reimbursementUnraveling the complexities of Medicare, Medicaid, and Third Party InsuranceNAVIGATING THE INS AND OUTS OF THE CLAIMS SUBMISSION PROCESSKnow when documentation must be submitted with the claimThe elements of an incident-to claimRecognize CCI edits (bundling) and understand how and when to unbundleDOCUMENTATION, DOCUMENTATIONWhat to do if you have been downcodedHow to analyze and solve difficult billing problemsWhat to look for with a denial for medical necessityUnderstand what to use from the documentation for an appeal or correctionEFFECTIVE TECHNIQUES FOR BETTER BILLINGHow to avoid the most common errorsKnow when to appeal and when to “write it offâ€Understanding the importance of physician profilingNews from the CMS front that may impact your billingFacultyDebra Mitchell, MSPH, CPC-HDebra Mitchell, MSPH, CPC-H, is a coding and compliance consultant and auditor, drawing from 30 years of experience in the field. She also shares her expertise through nationally presented continuing education events to benefit those working in various coding and billing roles. Debra has contributed to the development of a coding certification program and supervised a statewide Medicaid “peer review†program. Her commitment to the specialty is reflected as Debra maintains active membership in the American Academy of Professional Coders and is certified in hospital coding.Speaker Disclosures:Financial: Debra Mitchell receives a speaking honorarium from PESI, Inc.Non-financial: Debra Mitchell is a member of the American Academy of Professional Coders.
