Many Providers are experiencing increased payer audits, are dealing with prepayment reviews, and are receiving letters for large overpayment demands. Some are being terminated from participation, and even charged with fraud. Learn about some of the top issues and how to mitigate risk through documentation content compliance, and the benefits of implementing an effective compliance program.
Overpayments happen because of incorrect Coding, insufficient documentation, medical necessity errors, processing and other administrative errors. We will walk through the overpayment demand and recovery process and discuss what providers need to know about validating demand amounts, hiring an experienced attorney if necessary, payment options, rebuttals, and appeal rights.
- Determine if you need legal representation
- Retaining an expert
- Getting a second opinion
- Know your rights
- How to avoid future overpayments
- Medicare vs Commercial recoveries
Areas Covered in the Session:
- Why overpayments happen
- What you can do to mitigate them
- Why you may need legal representation
- The demand letter
- Validating the integrity of the results
- Submitting a rebuttal
- Different levels and Submitting an Appeal
- Judicial review
- Live Q&A Session
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Who Should Attend:
- Practice Managers
- Revenue Cycle Managers
- Compliance Officers
- Chief Operating Officers
About the Presenter:
With more than 33 years of clinical and administrative healthcare experience, Alicia Shickle specializes in documentation and coding, revenue cycle integrity, and both voluntary and mandatory compliance program development and implementation. She frequently works with business litigation and health law practices, serving on fraud and abuse intervention teams and providing litigation support.
Her past experience includes working as the director of compliance for the world’s largest healthcare training and credentialing organization, with more than 175,000 members worldwide who work in medical coding, medical billing, clinical documentation improvement, medical auditing, healthcare compliance, revenue cycle management, and practice management. She served as a director of coding and compliance, and was a family practice administrator. In this role, she accomplished the first level 3 PPC accreditation in New York state, and her practice won IPRO awards for most improved. Shickle has presented educational and training seminars nationally on compliance, documentation and coding, and practice management. She is a frequent author for online physician blogs and journals.
Shickle is the president-elect of the AAPC Manhattan local chapter. She is an Accredited Health Care Fraud Investigator (AHFI) and is certified in Healthcare Compliance (CHC, CPCO). She is a Certified Professional Coder (CPC), a Certified Professional Medical Auditor (CPMA), certified in Risk Adjustment Coding (CRC), and a Certified Professional Practice Manager (CPPM).
She is an active member of the American Academy of Professional Coders (AAPC), the Health Care Compliance Association (HCCA), the Association of Fraud Examiners (ACFE), the National Health Care Anti-Fraud Association (NHCAA), and the American Health Lawyers Association (AHLA).
Operating System: Windows any version preferably above Windows Vista & Mac any version above OS X 10.6
Internet Speed: Preferably above 1 MBPS
Headset: Any decent headset and microphone which can be used to talk and hear clearly
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Toll-Free No: 1-302-444-0162