E/M Auditing Fundamentals

This E/M Auditing webinar will explain how to get start with an auditing program in your healthcare organization and expand your knowledge of evaluation and management coding and auditing that will help you to increase revenues, decrease denials, rejects, and assist your organization in being compliant.

Greater scrutiny from the OIG, government-contracted and third-party auditors make practice self-checks of physician E/M coding is more important than ever. CMS sees physician education and outreach as critical parts of an effective enforcement strategy and clarify policies when inconsistencies in billing practices arise.

Why You Should Attend:

The fiscal year (FY) Medicare FFS program improper payment rate is 9.51 percent, representing $36.21 billion in improper payments. “Best practices” in healthcare have an effective compliance plan in place that contains all seven elements. One of those elements is “auditing”.

This is an opportunity to look at your current process as well as obtain useful information on how to get started with an auditing program in your organization. Proactive review with auditing your claims prior to submission will increase revenues, decrease denials, rejects, and assist your organization in being compliant, so when you receive revenue – your will “get to keep it” because you are lower the chances of improper payment activities by implementing “best practice auditing essentials”.

Attend this webinar to enhance your understanding of level-of-service audits to improve audit proficiency by reducing risk and promote accurate claim submissions in your healthcare organization.

Learning Objectives:

  • Did you know if you are billing for a Federal program, Medicare/Medicaid, the organization should have a compliance plan?
  • Do you have an effective compliance plan in place that includes auditing and monitoring?
  • Are you conducting random audits on E/M coding documentation before submitting to carrier?
  • Is your team proficient in determining medical necessity verses medical decision-making?
  • What percentage of undercoding/upcoding does your providers have?
  • Are you confident that your coding practices are compliant with the regulations set forth by private and government payors?
  • Is there regular communication between your providers and staff on how to use documentation to maintain compliance and proper reimbursement?
Areas Covered in the Session :

  • Gain useful information and tools for understanding the E/M auditing process
  • Increase your understanding of documentation requirements for the three key components – history, exam and medical decision-making.
  • Take a proactive stance and learn to implement your own self-audit procedures. Conducting your own audits is considered “best practices.”
  • Review the seven steps of an effective compliance plan.
  • The benefits of establishing an effective chart audit process
  • Step-by-step review of documentation requirements for ’95 vs. ’97 guidelines
  • Guidance on selecting the level of medical decision-making
  • Hands-on demonstration for aligning documentation to key components for “telling an accurate patient story”
Who Should Attend:

  • Medical billing and coding teams
  • Auditors
  • Medical Practice Managers/Administrators
  • Physicians
  • Clinical and practice staff involved in coding
  • Compliance Officers/Committees
  • Revenue Cycle Management Professionals

HC2822

Pamela Joslin

Pam Joslin, MM, CMC, CMIS, CMOM, CMCO, CEMA, CMCA-E/M, has more than 20 years of medical practice management, billing, and coding, reimbursement, compliance, and auditing experience.

She is an engaging presenter via webinar, classroom, and conference on various topics that may impact each step in the life of the revenue cycle of every practice.

She has managed in medical practices ranging from single to multi-specialty groups, including ASC. She is an advocate of process improvement and maximizing and empowering employees to bring about the “best practice” results for your organization.

She received her Masters in Management from the University of Phoenix. Pam maintains memberships in professional organizations to support her continuing cycle of learning in the ever-changing healthcare industry.

Pam is Owner and Operator of her own consulting business, Innovative Healthcare Consulting.

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  • Login Information with Password to join the session, 24 hours prior to the webinar
  • Presentation Handout in .pdf format
  • Presentation from the Speaker
  • Feedback form
  • Certificate of Attendance
  • Recording access Information with Password to view the webinar, will be sent 24 hours after the completion of the Live webinar.
  • Presentation Handout in .pdf format
  • Certificate of Attendance