Master 2024 CMS Interoperability and Prior-Authorization Rules for Faster Payor’s Approval

Course Description:

Centers for Medicare & Medicaid Services (CMS) issued the final rule for CMS Interoperability and Prior Authorization, which aims to improve prior authorization processes and enhance patient, provider and payer access to interoperable patient data.

Prior Authorizations serve as a cost containment strategy that third-party payers leverage to control costs, restrict patient access to services, testing, and medications, and ultimately discourage medical providers from ordering unnecessary medical treatment. Prior authorizations are a major source of headaches for healthcare providers across the country. Despite the intention to control costs and ensure appropriate care, the prior authorization process has been criticized for its enormous administrative burden, potential delays in necessary medical treatment, and added complexity for healthcare providers.

Striking a balance between cost control and efficient patient care remains a major challenge in the healthcare industry. Join us for an insightful webinar where expert Don Self will take a deep dive into the complexities of the Prior Authorization process, discuss the pearls and pitfalls, define medical necessity requirements, and demystify the intricacies of obtaining prior authorizations, ensuring a smoother workflow and higher approval outcomes in 2024. Don will also discuss the CMS Interoperability and Prior Authorization Rule and how significantly impacts payers approval and denial practices.

Learning Objectives:

Understand the major Prior Authorization Updates for 2024
Understand CMS Interoperability and Prior Authorization Final Rule
Recall medical necessity and the critical role it plays in the Prior Authorization approval process
Identify which insurance payers require Prior Authorizations
Recall methods for obtaining Prior Authorizations in 2024
Recognize common challenges experienced when obtaining Prior Authorizations
Understand how to escalate and appeal Prior Authorization denials

Areas Covered in the Session:

CMS Prior Authorization Updates for 2024
CMS Interoperability Rule
2024 Prior Authorization requirements for Medicare Advantage Plans
Define medical necessity and the critical role it plays in the Prior Authorization approval process
Regulatory landscape for Prior Authorizations in 2024
Identify which insurance payers require Prior Authorizations in 2024
Methods for obtaining Prior Authorizations
Common challenges experienced when obtaining Prior Authorizations
Outline successful strategies to overcome challenges with obtaining Prior Authorizations
How to escalate and appeal Prior Authorization denials in 2024
Best practice compliance tips for Prior Authorizations

Suggested Attendees:

Medical Providers
Administrators
Office Managers
Medical Billers
Claims Coders
Billing Staff and Companies
Physicians and Other Providers
Healthcare Consultants
Compliance Officers
Practice Manager
In and Out of Network Providers
Medical Billing Companies
Providers Office Staff
Hospitals and Facilities
Insurance Companies
Healthcare Attorneys

About the Presenter:

Don Self, CPC, CMCS, CASA, is the CEO and founder of Don Self & Associates, a consulting firm specializing in medical reimbursements and helping physician practices improve patient outcomes and increase profits while staying compliant with all regulations. Don is also the President of Telecare-USA. Don has taught more than 900 seminars/ webinars over the past 38 years to tens of thousands of physicians, NPPs, coders and billers on coding, revenue, reimbursement and billing and 49 webinars in 2020 on Telehealth Billing. He has helped thousands make sure they are paid properly by Medicare and other payers.

Additional Information:

After Registration: You will receive an email with login information and handouts (presentation slides) that you can print and share with all participants at your location.

System Requirement:

Internet Speed: Preferably above 1 MBPS
Headset: Any decent headset and microphone which can be used to talk and hear clearly

Can’t Listen Live?

No problem. You can get access to an On-Demand webinar. Use it as a training tool at your convenience. For more information, you can reach out to the below contact:
Toll-Free No: 1-302-444-0162
Email: care@skillacquire.com

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Testimonials:

"This program on HIPAA did a great job providing actionable concepts in a way that updated our team and me, I now know how I will implement the concepts because I already did it in their online seminar, it was easy to ask questions from the speaker at the end of my 60 minutes course"

Melissa Preston, Health Information Management Staff

"David Vaughn covered the material completely and I have a new understanding of when, where and why we need to use an ABN"

Sandie Fowler, Out of Network Billing Staff

"Great presentation. Able to do during the day. Timing was great"

Tina Duffy, Compliance Officer

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