Insurance Coding and Billing for the Medical Office Seminar training classes conferences & workshops presented by Cross Country Education Seminars register for training on FindaSeminar.com

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Training Course Syllabus:

Insurance Coding and Billing for the Medical Office

PROGRAM DETAILS

The 2008 CMS Payment Report Update shows that during 2006-2007 Medicare UNDERPAID claims by $900,000,000 (Nine Hundred Million Dollars). This translates into YOUR practice's money that is sitting out there waiting for you to claim it. In the majority of cases, improper coding and documentation was the culprit. Of the claims rejected by Medicare, 57.7% of the errors are due to coding mistakes and 27% due to insufficient documentation. Routinely a practice will resubmit only 40% of the claims that are rejected, due to issues with documentation being insufficient for an appeal. The medical billing process starts long before the patient actually arrives for the appointment and continues after the patient leaves the office. Medical billing and collection problems often occur as a result of oversight or error and in some instances due to lack of knowledge in the billing department. Reimbursement involves the complex system of ICD-9 and CPT codes for diagnosis and procedures and on coordinating and properly submitting those codes. The financial success of the practice and a positive cash flow depends on proper reimbursement. Dealing with denied and rejected claims can be costly and frustrating!

The purpose of this one-day seminar is to help you understand the claims process and avoid unnecessary back end work. Optimal reimbursement means to submit a claim once and be reimbursed the FIRST time you submit it. Attendees will discover tips and techniques to help achieve this goal for timely and optimal reimbursement. Examine the most common reasons for claim denials and how to correct them. Discover how to document for medical necessity and determine when to appeal if a claim is rejected. Learn how to handle downcoding, decipher an EOB and navigate the "ins and outs" of billing Medicare, Medicaid and private party insurance. Participants will leave with a better understanding of how to effectively utilize CPT, ICD-9, 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!!

WHAT YOU WILL LEARN

• Discuss diagnosis coding and linking ICD-9 to CPT codes to ensure you aren't coding creatively just to conform to payment policies
• Examine how modifiers can be used effectively for reimbursement
• Determine how to effectively navigate the ins and outs of Medicare, Medicaid and private party insurance
• Understand documentation requirements and recognize the components of a good narrative
• Discover how to code your claim correctly the first time you submit for maximum reimbursement and fewer hassles!

• Maximize your reimbursement by emphasizing proper coding
• Examine how documentation can make or break an appeal
• Determine when to appeal and when to submit a corrected claim
• Identify when to use attachments
• Outline how to write proper appeal letters
• Explain how to treat medical necessity denials
• Analyze the credentialing process and what it means to your practice
• Identify what your EOB and insurance contracts mean
• Discuss tips and techniques to obtain optimal and timely reimbursement
• Examine how profiling your physician can translate to maximum reimbursement
• Learn about bundling and how or when to unbundle codes
• Illustrate proper submission of incident-to claims
• Recognize what downcoding is, how to fight it and avoid it

ABOUT THE SPEAKER

Debra Mitchell, MSPH, CPC-H, is a consultant and auditor for coding and compliance as well as a professional instructor in coding, billing and medical terminology for adult education at the college level. Her educational experiences coincide with her 30 years of medical records and billing experience at every level of responsibility. Ms. Mitchell is a member of the American Academy of Professional Coders and is certified in hospital coding. As an auditor, she performs routine audits and provider education for an orthopedic billing service. In addition, she works for a consulting firm which specializes in cardiology. She has developed several courses for adult education programs in medical coding and billing at the college level and has contributed to the development of a coding certification program. She supervised a statewide Medicaid "peer review" program, which conducted quality reviews of services provided to the recipients, medical record documentation and correct coding audits. Her teaching ability is reflected in the professional success of her students and her excellent evaluations. Debra Mitchell brings an effective communication style to this very important subject and will provide an enjoyable and worthwhile learning experience. She was recently named to the Biltmore's Who's Who in America's Professional Women.

TESTIMONIALS

WHO SHOULD ATTEND

• All Coding and Billing Personnel
• All Physicians
• Physician Assistants
• Nurse Practitioners
• All Office Managers
• Medical Assistants
• Cross-Training Receptionists, Cashiers
• Anyone responsible for medical services reimbursement

CREDITS

This program has prior approval by the American Academy of Professional Coders for 6.0 Continuing Education Units. Granting of prior approval in no way constitutes endorsement by AAPC of the program content nor the program sponsor. Full attendance is required to receive credit for Coders; variable credit for partial attendance may not be awarded based on the AAPC guidelines.

Cross Country Education, LLC is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
This course is offered for 6 contact hours.

Insurance Coding adn Billing for the Medical Office has been submitted to the Professional Association of Health Care Office Management for approval of 6 CEUs.

Cross Country Education is approved by the California Board of Registered Nursing, Provider #CEP 13345, for 7.2 contact hours.

This program/activity has been submitted to the American Association of Medical Assistants (AAMA) for 6.0 Continuing Education Units.

Cross Country Education is an approved provider by the Florida Board of Nursing, provider #50-466. This course is offered for 7.2 contact hours.

Cross Country Education is an approved provider with the Iowa Board Of Nursing, approved provider #328. This course is offered for 7.2 contact hours.

Cross Country Education is approved as a provider of nurse practitioner continuing education by the American Academy of Nurse Practitioners. Provider number: 060313. This course is offered for 6.0 contact hours.

This program is not yet approved for CME credit. Conference organizers plan to request 6 hours of AAPA Category I CME credit from the Physician Assistant Review Panel. Total number of approved credits yet to be determined.

This seminar qualifies for 6 continuing education hours as required by many national, state and local licensing boards and professional organizations. Save your course outline and certificate of completion, and contact your own board or organization for specific filing requirements.

SEMINAR CLASS TIME:

Seminar Check-in:  7:30 AM    Seminar Class 8:00 AM - 3:30 PM

Seminar Summary:

Discover the most efficient way to prepare claims, submit and follow up! Included will be Medicare, Medicaid and Third Party Insurance.  (see full course description)

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