Insurance Coding and Billing for the Medical Office: 2019
Digital Seminar

Insurance Coding and Billing for the Medical Office: 2019


Faculty:
Debra Mitchell
Duration:
5 Hours 27 Minutes
Format:
Audio and Video
Copyright :
Sep 19, 2018
Product Code:
POS020684
Media Type:
Digital Seminar


Description

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!!

Credits

**

NOTE: Tuition includes one free CE Certificate (participant will be able to print the certificate of completion after completing and passing the on-line post-test evaluation). 

Continuing Education Information:  Listed below are the continuing education credit(s) currently available for this non-interactive self-study package. Please note, your state licensing board dictates whether self-study is an acceptable form of continuing education. Please refer to your state rules and regulations. If your profession is not listed, please contact your licensing board to determine your continuing education requirements and check for reciprocal approval. For other credit inquiries not specified below, please contact cepesi@pesi.com or 800-844-8260 before the event.

Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of mental health professionals.  As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice in accordance with and in compliance with your professions standards


California Nurses

PESI, Inc. is a provider approved by the California Board of  Registered Nursing, Provider #: 13305 for 5.5 self-study contact hours. 

** You will need to provide your license number to PESI. PESI must have this number on file in order for your hours to be valid.


Florida Nurses

CE Broker

PESI, Inc. is an approved provider by the Florida Board of  Nursing. Provider #: FBN2858. These materials qualify for 5.5 self-study contact hours.

** Florida Participants Only: To automatically be reported to CE Broker, after completing and passing the online post-test/evaluation, please contact cepesi@pesi.com. You will need to provide the full title of the activity, speaker name, date of live broadcast, your name and your license number in the email.


Iowa Nurses

PESI, Inc. is an approved provider by the Iowa Board of Nursing. Provider #: 346. Nurses successfully completing these self-study materials will earn 5.9 self-study contact hours. Please email cepesi@pesi.com with your license number, include the title, speaker name and date. PESI must have this number on file in order for your hours to be valid.


Nurses, Nurse Practitioners, and Clinical Nurse Specialists

This self-study activity consists of 5.75 clock hours of continuing education instruction. Credit requirements and approvals vary per state board regulations. Please save the course outline, the certificate of completion you receive from this self-study activity and contact your state board or organization to determine specific filing requirements.


Other Professions

This self-study activity qualifies for 5.75 continuing education clock hours as required by many national, state and local licensing boards and professional organizations. Save your activity advertisement and certificate of completion, and contact your own board or organization for specific requirements.


Handouts

Faculty

Debra Mitchell Related seminars and products: 2

MSPH, CPC-H


Debra 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.


Additional Info

Program Information

Access for Self-Study (Non-Interactive)

Access never expires for this product.


Objectives

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

Outline

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

Target Audience

  • Coding and Billing Personnel
  • Medical Records Personnel
  • Office Managers
  • Physicians
  • Medical Assistants
  • Nurse Practitioners
  • Nurse Managers and Nurses

Reviews

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Your satisfaction is our goal and our guarantee. Concerns should be addressed to: PO Box 1000, Eau Claire, WI 54702-1000 or call 1-800-844-8260.

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