Learn more about this event

Understanding what is meant by medical necessity is a critical concept for a health care provider to not only be paid and to be paid correctly, but to avoid an allegation of an overpayment should Medicare, or another payer, request supporting documentation for claims submitted. Coders and billers submitting claims as well as physicians and nonphysician practitioners documenting services ordered or provided all need to have a good grasp of how payers make a medical necessity determination. This webinar will review recent findings from CMS contractors such as the CERT contractor and certain Medicare Administrative Contractors and how to apply these findings not only for proper reimbursement but also how to determine what documentation to submit when responding to a payer’s request for records.

Agenda

• Medical Necessity defined
• Documenting Clinical Indications is not just a Problem List
• Tips to Avoid Denials

You rated this event: