The Center of Medicare and Medicaid Services (CMS) has created two data files that assist in coding policies and guidelines utilized for Medicare claims but also used by commercial insurance carriers for the processing of medical claims submitted by physicians and other qualified healthcare professionals. The difference between payment or denial is determined by the application of the information from these files. When those creating or processing medical professional claims those who know and understand how to use the files will assist them to submit claims correctly. This information also explains why a claim or claim line is denied and if it can be corrected. This webinar will show attendees how to use these files properly for timely reimbursement.

Session Highlights:-

• Procedure to Procedure Edits
• Medically Unlikely Edits
• NCCI Policy Manual
• Bundling denials
• Unbundled claims
• RVU values
• Postoperative period- minor or major
• Active services and procedures
• Supervision for diagnostic testing
• Coding for bilateral services

Who Will Benefit?

• Consultants
• Auditors
• Compliance officer
• Physician
• PA
• Nurse
• Biller
• Coder
• Collector
• Claims representative
• Claims adjuster
• Claims processor
• Manager
• Supervisor
• Administrator
• Medical assistants
• Office staff
• Medical offices
• Billing companies
• Insurance companies
• Consulting firms

Anyone who codes and bills medical claims for professional services will be benefited.