Who Should Attend This Course
Practice Executives, Administrators, and Practice Managers
You are the chief compliance officer in most private practices. In order to supervise the economic engine of the practice you must understand the business office operations.
Coders and Billers
If you’re responsible for entering data, working denials, applying modifiers, posting payments, and filing appeals, your expertise in surgical and office coding must be exacting in its execution!
Hospital or MSO Executives Running General Surgery Practices
Maximize your profits! Understand what is special and unique about billing for the general surgery service line, and keep your surgeons happy and bonus-able. (Not to mention reduce compliance headaches.) Learn the rules and avoid using incorrect and expensive assumptions that result in fiscal disaster.
Team Attendance Produces The Best Results!
Getting paid is a team effort—and surgeons lead the team. If the doctors don’t understand what’s needed in an operative report from a coding and reimbursement point of view (something they don’t teach in residency) they are short changing themselves.
As a result of this course participants will be able to:
- Select the correct category and level of E&M services.
- Assess the risk of an EHR’s built-in coding features.
- Improve the accuracy of ICD-10 coding and avoid denials and payment delays.
- Correctly bill for non-physician providers.
- Implement systems for point of service collections and pre-surgical deposits.
- Sharpen financial report review and analysis.
What’s on the Agenda
How You Get Paid: The Mechanics of Coding
- Nuts and bolts: CPT and HCPCS codes and modifiers
- What is it worth: How fees are set
- Look inside the box: What’s included in the global payment
- Evaluation: Before a minor or major procedure
- Definitive guide to documenting time
- Category of code: Select the correct category to prevent payment denials and delays
Don't Let the EMR Run Away with You
- Accurate E&M code selection and understanding audit risks
- Consider the nature of the presenting problem and medical necessity
- How your medical record’s E&M advisor leads you astray
- Critical care
- Screening colonoscopy
ICD-10 Issues and Problems
- Medical necessity, NCDs, LCDs
- Injury coding
- Sequela, aftercare, surveillance and post-procedural complications
- Watch list: Denials based on ICD-10 codes in surgical practices
- .8 is great, .9 not so fine
- Case examples
Non-Physician Practitioners in a Surgical Practice
- Roles, revenue
- Medicare incident-to and shared services
- Bonus guide to the teaching physician rules
Reporting and Revenue Cycle
- Reports you need to see
- Key financial indicators
- Surgery deposits
- Preventing denials, learning from denials
- Patient coll