Reimbursement Opportunities Hidden in Coding, Documentation, and More
Course Description:
Often times the importance of proper documentation to meet appropriate code selection is overlooked in a facility. Proper code selection, and thus documentation is an important area for reimbursement opportunities. With the addition of several care management codes, along with population health, many facilities have either overlooked or not had time to be properly educated on the financial impact of assigning these codes. Payors have begun using artificial intelligence, in the form of algorithms, to potentially downcode, or pay less, than the worth of the code submitted. Expert Susan Rohde, RHIT, CCS-P, CPC will provide you the step by step guidance on identifying the potential reimbursement opportunities within the coding and documentation.
Learning Objectives:
- What types of services are allowed in certain settings
- Understand how documentation affects code assignment
- Understand how code assignment can affect payment
- Know how code assignment affects payors that reimburse on a fee schedule
- Understand how care management codes can help in reimbursement
- Understand how improved documentation and coding can help increase reimbursement
- Understand common challenges, opportunities, and strategies that exist in achieving proper documentation and code selection
- Population Health opportunities within your facility
- Identify Payor Downcoding
Areas Covered in the Session:
- Care Management Codes and requirements to assign them
- 2025 Documentation guidelines for office and IP/ED/OB visits
- Updates from the 2025 MPFS Final Rule
- Types of services allowed in different setting
- Documentation impacts on code assignment
- Code assignment effect on payment or reimbursement
- Payor Downcoding
- Population Health codes and requirements to assign them
- Live Q&A Session
Suggested Attendees:
- Healthcare Providers or Physicians
- Administrators
- Medical Billers
- Claims Coders
- Revenue Cycle Managers
- Billing Staff and Companies
- Physicians and Other Providers
- Healthcare Consultants
- Compliance Officers
- Office Managers
- Practice Manager
- Chief Financial Officers
- In and Out of Network Providers
- Medical Billing Companies
- Hospitals and Facilities
- Insurance Companies
- Healthcare Attorneys
About the Presenter:
Susan Rohde, RHIT, CCS-P, CPC, has more than 28 years of experience in health care industry with an emphasis in coding, health information management, medical necessity and documentation. Susan is currently serving on the education committee for NSCHBC. Her other memberships include AHIMA, NDHIMA, AAPC, NSCHBC, HFMA and MGMA. She specializes in reviewing documentation for accurate reimbursement within Evaluation and Management (E/M) and all surgical specialties, including Interventional Radiology, Anesthesia, Neurosurgical, and Orthopedics, for both ICD-10-CM and CPT codes. Susan helps navigate the ever-changing coding and documentation world and can help your organization in maximizing its coding potential via proper documentation, provider and coding staff education, and understanding of guidelines and regulations.
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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Melissa Preston, Health Information Management Staff
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Sandie Fowler, Out of Network Billing Staff
"Great presentation. Able to do during the day. Timing was great"
Tina Duffy, Compliance Officer