In a textbook environment, everything comes through easy and perfect for professional fee reimbursement – but that is not the real-world experience! Over the past decade, health information professionals have seen many changes to the documentation and coding world. With the implementation of electronic medical records, there have been many compliance risks in professional fee coding and reimbursement.
This presentation will provide an in-depth look at the most common issues seen during compliance audits for professional fee reimbursement and provide helpful tips in identifying those risks and how to avoid them. Documentation issues, templates, cloned notes, modifier usage, physician’s as the coding professional, nonphysician practitioner issues (incident to/split shared guidelines), teaching physician guidelines, critical care, and more will be explored.
October 8, 2019
1.0 AHIMA – External Forces
1.0 AAPC – External Forces
Jacquelyn Craver, RHIA, CCS, CCS-P
Senior Coding Compliance Auditor, Healthcare Cost Solutions, Inc.
Ms. Craver has over 20 years of experience as a health care consultant with a focus on coding, auditing, education and compliance. She has developed a proficiency in the facility outpatient and professional fee services focusing on multi-specialty surgery, clinics, observation, emergency room, evaluation and management services, infusion centers and interventional radiology/cardiology. She also prides herself in her commitment to health care ethics, quality and compliance