Online Training Course

Prod ID: 309
Making the Case for Mod-High Risk E/M Services

Dive into documentation and the “Medical Necessity” of the encounter - ensuring a Moderate or High-level Medical Decision Making is also supported. Get clear on when to bill legitimately and confidently for higher-level services based on Moderate - High MDM.

CEUs

1

Length

55 min

Price

$97

Learn provider documentation and the “Medical Necessity” of the encounter - ensuring a Moderate or High-level Medical Decision Making is also supported. Get clear on when to bill legitimately and confidently for higher-level services based on Moderate and High MDM.

Sean Weiss


Sean serves as Chief Compliance Officer for numerous nationally recognized health care organizations; engaged in the development of customized Corporate Compliance Programs including Standard Operating Procedures (SOPs), Policies, Corrective Action Plans, Investigations and maintaining their Culture of Compliance. He is a Partner, DoctorsManagement, where he has been recognized by clients for successfully protecting their organization from unwarranted penalties and ensuring they receive due process. He has protected thousands of physicians, medical practice groups, and hospitals from undue penalties. In his medical audit appeal defense work, Sean and his team of auditing and compliance experts have a proven record of having claims dismissed that had been brought against large and small healthcare organizations targeted by federal (Medicare), state (Medicaid), and commercial insurance payors.

Learn from a regulatory and compliance professional working the front-line of audit appeal defense on a daily basis. Gain new insights and identify steps and techniques used to successfully defend clients during a payor audit.

Audits began to ramp-up in August 2020, based on CMS’ notification. This means Auditors at CMS and other private payors are dusting off their resource manuals. They’ve been a bit vague in the past regarding the highly subjective portions of Evaluation and Management Services, leading to potential denials of services or down-coding of services without proper cause.

This session will focus on provider documentation and the “Medical Necessity” of the encounter - ensuring a Moderate or High-level Medical Decision Making is also supported. Get clear on when you can bill legitimately and confidently for higher-level services based on Moderate and High- Medical Decision Making.

Don’t miss this opportunity to hear from a regulatory and compliance professional working the front-line of audit appeal defense on a daily basis. Sean will share insights and identify steps and techniques used to successfully defend clients during a payor audit.

Self-paced online program includes unlimited review of previously recorded instruction and the downloadable PowerPoint handout for 6 months.

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