Betsy Nicoletti

Medical Coding and Compliance Expert, Speaker, Educator, and Auditor

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TCM and CCM Codes: Advanced strategies to secure reimbursement, avoid denials

CCM and TCM are complex services, which may be a reason why practices that could benefit from them don’t try. A 2015 survey found only 22% of practices had a CCM program, and only half of them had successfully submitted a claim. Billing for TCM is up, but CMS keeps adding new rules for it – for example, in 2015 they changed the date-of-service requirements – which providers may find confusing. In fact, some providers are outsourcing their CCM and/or TCM work.
Participants will learn

  • The basic MDRs for each service-what you have to do to bill
  • Levels of support your practice needs to perform CCM or TCM
  • Changes CMS has made to TCM and CCM requirements since they were introduced in 2013 and 2014
  • The pros and cons of outsourcing CCM or TCM services
  • The most common reasons for denials of claims for both services, and how to avoid them

Filed Under: Presentations

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“My organization approached Betsy Nicoletti because we had providers failing coding audits.

Betsy’s name is out there in the coding world as a leader in the field and wanted the best for our providers.

Betsy works with the organization to set up webinars for our new provider on boarding training process (which according to them has been most beneficial), as well as subsequent auditing to ensure provider engagement and understanding.

Betsy’s one on one approach has helped the organization overall by the specialized attention to our specific needs.

I appreciate Betsy’s tactful approach with the providers to lessen their concerns as it relates to proper coding. She is up to date on all of the current changes in coding and maintains the communication whenever warranted.

Overall I have found the experience of working with Betsy as positive and educational. I would not hesitate to recommend Betsy to any organization that needs to improve their coding practices and improve success rates from outside auditing.”

Julie D., LPN
Clinical Performance/Operations Manager

• Develop agenda with Betsy*
• Betsy will customize presentation and prepare learning materials
• 90 minute Zoom, live education session
• 30 days Q&A follow up
• Recording of session to show new hires
• Interactive: everyone hears the same thing and can ask questions

*Betsy’s area of expertise doesn’t include all procedural coding – email to set up a time to discuss your needs