Reimbursements – How To Keep Them Or Be Prepared To Defend Them In An Audit

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Providers are entitled to be reimbursed for the healthcare items and services they provide. However, every payor, federal and commercial, has their own rules for coverage and reimbursement and those rules often don’t comport with the clinical medical judgment for the best care and treatment of the patients. This session is structured to explain the key terms of art in reimbursement and how to best keep the money that you receive. In the event of an audit, the dos and don’ts in this seminar will help providers set up processes and policies to effectively defend against audits and conduct proactive internal audits.

Learning Objective:

• Understand reimbursement from a payor perspective
• Understand the various types of audits and reviews and related appeals processes
• Learn practical tips for internal record-keeping and billing processes to maximize retention of reimbursements

Areas Covered in the Session:

• Healthcare CEOs
• Healthcare CFOs
• Chief Compliance Officers
• Chief Operation Officers
• Chief Finance Officer
• Chief Medical Officers
• Healthcare providers
• Compliance managers and directors
• Billing and coding managers and directors
• Managing officers and directors
• Physicians
• Practice Managers
• Billing and Coding Professionals
• Healthcare Attorneys and Legal Staff
• Medical Providers including Registered Nurses, Physician Assistants, and Administrative Staff
• Customer Service Managers
• Risk Managers
• Live Q&A Session

Suggested Attendees:

• Compliance managers and directors
• Billing and coding managers and directors
• Healthcare providers

Presenter Biography:

Courtney G. Tito, is a Partner at Nelson Mullins in its Boca Raton, Florida office. She is Board Certified in Health Law by the Florida Bar. Courtney counsels clients in federal and commercial payor audits, disputes and investigations. She also counsel clients regarding revocations and payment suspensions and in responding to federal subpoenas and civil investigative demands. Courtney counsels clients in regulatory and compliance matters at both federal and state levels. Courtney represents a variety of provider types, including laboratories, pathologists, physicians, and physician groups. She also regularly speaks on regulatory, audit and payor disputes.

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