Conference Materials (Password Required)

Whether you want it or not, it’s coming. The dreaded letter stating that you owe money and they want it. Everyday thousands of providers are audited and then sent notice of overpayment demand letters. The first line of audit response is in the correspondence received by your practice. Simply accepting the terms laid out in demand letters, subpoenas and audit notifications could prove to be a huge mistake for your practice. You can reverse these investigations, audits and recoupment request with an effective response to these demand letters.

Compliance Expert J Paul Spencer, walks you through the different types of audit correspondence you may receive, the level of importance of each, and tips for successful response to the payer. It’s all in the response! Paul will help you successful response plan, but also he will tell the step-by-step process every practice must utilize to successfully respond to every type of demand letter you might receive.

Learning Objectives:

• Understand what types of demand letters a practice might receive
• Understand what the letters are actually requesting
• Know when the matter can be handled at the practice level
• Learn when it might be beneficial to get a 3rd party opinion
• Understand when legal counsel is useful or required
• Review and Dissection of Various Types of Audit and Investigation Letters and How to Approach Each
• Lean best practices for defending Overpayment Recoveries
• Understand medical necessity
• Understanding False Claim Act

Areas Covered in the Session:

• ADRs (Additional Documentation Request)
• The False Claims Act
• Medical Necessity
• SIU (Special Investigative Unit) Overpayment Demand
• Notice of Investigation vs Demand for Records
• Responding to Payer
• Appeal Documentation
• Reversing Payer Decision
• Types of Audit and Investigation Letters
• Approaching Techniques to different Audits and Investigation Letter
• Defining “Medical Necessity”
• Commercial Payor Trending Report
• Recovery Audit Contractor
• Unified Program Integrity Contractor (UPIC)
• Overpayment Rescission
• Live Q&A session

Suggested Attendees:

• Billing Managers
• Practice Managers
• Providers
• C-Level Executives
• Office Staff and Billing Managers
• Medical Billing Companies
• Hospital Revenue Cycle Staff
• Physician
• Nurses
• Physician Assistants
• Nurse Practitioners
• Medical Assistants
• Practice Manager
• Office Managers
• Coders
• Auditors
• CDI Specialists
• Collection Staff
• Compliance Officers
• Telemedicine System Vendors
• Patient Accounts Personnel
• Medical Record Supervisors
• Health Information Management Administrators and Technicians
• Other Personnel Interested in Billing Privileges with the Medicare Program

Presenter Biography:

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This is a Live Virtual session.

A new way of immersive learning that allows you to engage live with our instructor and peers providing you with the flexibility to juggle the new work-life balance.

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