Medicare’s medical necessity programs have
been extraordinarily effective in reducing program
outlays. Medicare medical necessity rules are actually
voluminous benefits rules, not standard care practices.
To properly follow the rules requires communication
that starts with patient care and ends in the billing
office.
The 4.5-hour program covers the foundations of the
Medicare program and medical necessity including the
interpretation of local medical review policies (LMRPs).
Topics focus on the most common billing errors and
alert clinicians to the ones that have especially
costly results. The sessions help clinicians and service
providers to work together to find appropriate billing
information required to meet medical necessity guidelines.
Also covered are the billing instructions for preparing
Advance Beneficiary Notifications, or ABNs, when a
medical necessity check does show that Medicare will
not pay for a service.
The goals of this educational program are to:
- provide an understanding of Medicare medical necessity
rules when prescribing tests,
- demonstrate the importance of accurate diagnosis
coding,
- discuss how to establish communication between
prescribing clinicians and diagnostic service provider
staff, and
- provide the tools necessary to address medical
necessity rules on an ongoing basis.
Contact us for information
about the program
Return to Educational Seminars
|
