The sessions included in the MGMA 2016 Financial Management and Payer Contracting Conference were selected to provide timely and practical education on the most important financial management and payer contracting topics that impact today’s medical practices.

By taking advantage of up-to-date and relevant knowledge and tools, attendees will become better positioned to successfully manage the adaptation and change that are necessary in the current healthcare environment.

Medical practices can decrease denials and accelerate payments, by setting up work processes that use advance functions in their software systems to identify, quantify and categorize denials. The purpose is to identify patterns related to coding, enrollment, prior authorization and specific payer performance.

This presentation will focus on using these systems related specifically to ICD-10, but the underlying strategy to understand the causes of denials, and reduce or prevent them in the future is applicable for all denial reasons.

Participants will learn how to:

1. Assess your practice’s current denial process for effectiveness.
2. Identify revenue types and diagnosis code ranges,that are at highest risk of denial.
3. Develop one strategy to prevent diagnosis related denials.

This one and a half hour presentation is for clinicians, managers, billing and coding staff.

Description:
Surgical procedures are paid under the global surgical services rules, which include pre-operative, intra-operative, and post-operative services in a single payment. This session describes the CPT and CMS rules for the global package. There are some instances in which the physician can be paid for E/M or surgical services within the global period: this session will identify those circumstances and how to submit claims for the service.

Agenda:

• CPT and CMS definition of the global package
• Medicare Physician Fee Schedule indicators and global days
• Use of modifiers for E/M services before and during the global period
• Use of modifiers for surgical services during the global period

Learning Objectives:

• Define the components of the global surgical package
• Identify what services are separately reportable
• Describe how to submit claims, with the correct modifier, for global services and services that can be billed in addition

CEUs:
1.5 AAPC credits