Avoid Concurrent Care Denials
February 07, 2018 11:00am MT
Learn more about this event
Learn how to properly code and document services rendered by multiple providers in the same group practice to the same patient on the same date of service.
Why is this topic important?
According to a Merritt Hawkins 2017 Review of Physician and Advanced Practitioner Recruiting Incentives, 90% of their searches feature employment of the provider rather than a private practice model. This means multiple specialists who see the same patient on the same date of service are reporting their services under the same group practice and tax identification number. Unless these services are separately identifiable, payers will only reimburse one provider per patient, per date of service.
Who would benefit from this topic?
Physicians, mid-level providers, coders, insurance specialists, and billing manager would all benefit from this topic.
How would this benefit the individual and/or their company?
Understanding how to properly document each provider's management of different diagnoses will enable the services to be separately identifiable through CPT® modifiers and ICD-10-CM coding. The result is increased revenue and decreased denials for multi-specialty group practices.
What information/new skills will the attendee take away from this webinar?
The attendee will have a better understanding of the definition of "concurrent care" from a payer's perspective. The attendee will be provided with specific examples of documentation by multiple specialists providing care to the same patient on the same date of service and how to extract the appropriate diagnoses in order to accurately reflect the separate management of each diagnosis. Finally, the attendee will be provided with examples of how to appeal concurrent care denials.
Why is the presenter the expert on this topic?
I currently work for a 200+ physician multi-specialty physician group, and I am responsible for reviewing concurrent care denials for insufficient documentation, incorrect coding and making recommendations for improvement. Through this educational process, our concurrent care denials have been drastically increased.
- Concurrent Care - The Payer’s Perspective
- Understanding the NPI Registry & Payer Credentialing
- Rules To Code By
- The 1-2-3’s of Assigning Diagnoses by Specialty
- Billing for Hospitalist
- Billing for Cardiologist
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