Medical Fraud or Medical Necessity: Documenting Your Story (OnDemand Webinar)

$149.00

SKU: 409563EAU

Description

Gain an understanding of medical necessity and the importance of correct documentation.The difference between the government making a determination of medical fraud as opposed to medical necessity lies in your documentation. Physicians, hospitals, labs, longterm care providers, and all other medical providers must properly document that their services were medically necessary. This course will inform providers, compliance professionals, and billers of the meaning and interpretation of the term medical necessity. The course will also provide guidance for properly documenting the procedures and services performed. To better understand the impact of proper documentation of medical necessity, this material will focus on recent government prosecutions and settlements, particularly in areas of increased government focus, such as telehealth services. Gain practical tips and considerations for documenting medical necessity.

Date: 2022-04-20 Start Time: End Time:

Learning Objectives

The Definition and Application of the Term Medical Necessity
• Medical Necessity as Defined by CMS
• Medical Necessity as Defined by States
• Medical Necessity as Defined by the Courts

Appropriately Documenting Medical Necessity
• Document Type, Frequency, Extent, and Duration
• Standards of Practice
• Evaluation and Diagnosis Codes

Lessons Learned From Recent Government Prosecutions
• Overview of Recent Cases
• Potential Defenses

Practical Considerations
• Policies
• Internal Audits
• Results: Effective Communication, Correct and Timely Reimbursement, and Patient Safety

AHIMA ,Additional credit may be available upon request. Contact Lorman at 866-352-9540 for further information.

Theresa DeAngelis-Quarles & Brady, Kirti V. Reddy – Quarles & Brady