The American Medical Association revised Evaluation and Management (E/M) coding and documentation guidelines in 2021 and 2023 to reduce administrative burden and simplify the process, but payers continue to report E/M claims billed incorrectly and inappropriately. Learn how to review your providers' documentation to ensure correct assignment of E/M codes and implement your own internal E/M audit program.
1
65 min
$119.00
Gain knowledge of level-of-service audits. Ensure that chart documentation supports the claim submitted. Improve your aptitude for cross-checking and code selection. Review the general principles of medical record documentation and understand key elements impacting E/M billing, coding, and documentation rules.
In an era of increased audit probability, it is wise to take a proactive stance. Ongoing scrutiny from the OIG, government-contracted and third-party auditors make practice self-checks more important than ever. Improving E/M audit proficiency reduces practice risk and promotes accurate claim submission.
Highlights
Jan HaileyMHL, CMC, CMCO, CMIS, CMOM, CMCA E/M |
Jan Hailey has more than 30 years of experience in healthcare. She is proficient in administration, coding, and billing roles, and teaches medical office professionals around the country how to excel in their careers. Jan has also been instrumental in the development of PMI's Workforce Initiatives program.
Jan's affinity for teaching has helped countless healthcare providers and medical office professionals over the years. During her expansive career, she has served as Director of Quality for Saint Joseph Physician Network located in Mishawaka, IN, and Director of Care Management with Select Health Network, an entity of Saint Joseph Health System. As Care Management Director, Jan led the physician network and comprehensive interdisciplinary team across the health system working closely with providers, management, staff, community, and payers to develop strategies for process improvement, gap closures, and patient experience. She developed a documentation improvement program and a Hierarchical Condition Category (HCC) coding education program to predict future healthcare utilization by accurately reporting patient complexity.
Prior to joining Saint Joseph, Jan was the Director of Quality, Coding, and Compliance for one of the largest health systems in Northern Indiana. She has a Master of Health Leadership and four professional certifications in office management, coding, insurance processing, and compliance. She is a member of WPS Government Health Administrators (Medicare) Provider Outreach and Advisory Group.
Comments from past participants:
"It was very informative."
"Great refresher on auditing E/M services."
"Excellent program."