Click Here to view a replay of the "Surviving and Thriving in the Age of Healthcare Audit Accountability" Webinar! This session will provide a comprehensive overview of the evolving healthcare regulatory environment and the daily tactics and challenges every hospital must address in order to adhere to the Medicare Conditions of Participation (CoP) and the Centers for Medicare and Medicaid Services (CMS) policy as it relates to Medical Necessity. EHR subject matter experts will articulate the regulatory landscape surrounding the scope of retrospective recoupment strategies, describe the responsibilities of each Medicare and Medicaid Program Integrity Contractor, and explain some of the targeted areas of focus during government audits. Learning Objectives:
- Gain an understanding of areas at high financial and compliance risk related to misclassification of inpatient vs. observation status for admissions and readmissions.
- Learn strategies to manage a daily compliant medical necessity utilization review process, assess inter-rater reliability testing of the process, and ensure admission and readmission appropriateness.
- Find out how to best address the legal and regulatory challenges associated with False Claims Act actions that involve patterns of medical necessity denials.
- Observe and understand how EHR uses its Collective Physician Experience™ (CPEx™) database of more than 3.5 million medical necessity Physician Advisor reviews to further provide your hospital medical necessity compliance and ensure successful defense of claims denied by state and federal auditors.
* Note - Webnar Replays are NOT eligible for CEUs.