Practical Tips for Healthcare Audits & Investigations

Event Information
Product Format
Prerecorded Event
60 minutes
Product Description

Get Expert Tips on Preparing, Navigating & Responding Successfully Against a RAC, MAC or Any Government Audit.

Eliminating healthcare fraud and abuse has become a top priority for the CMS. Hospitals and clinics regularly face audits and investigations by Medicare, Medicaid and private insurers. Government investigations are on the rise and providers everywhere tremble at the thought of becoming the next investigative target.

In this LIVE webinar, expert speaker David M. Glaser will discuss steps you can take before an audit begins to be better prepared in the event you are audited. Planning is essential to navigating and appealing a RAC, MAC, or any government audit successfully. David will help you with audit preparation processes and mitigate the risk of future audits with accurate strategies.

You learn how to better respond to audits and investigations in this 60-minute webinar.

Session Highlights:

  • Legal arguments that can be used to defend against an audit, including arguments that can be used in situations where medical documentation is lacking
  • Practical tips for preserving communications with insurers
  • Tips for lowering your legal costs and getting the most efficient use of legal counsel
  • Appeal process for “initial determination” letter notifying an overpayment
  • How to conduct internal reviews
  • How to respond to contact from private insurers or government agencies
  • Presentation of your arguments. What is the best format to present your case
  • Documentation guidelines from CMS/HCFA and CPT®
  • Guidance for challenging documentation denials
  • Insights on medical necessity denials
  • What we can learn from the “treating physician rule”
  • Time limits on RACs
  • Know your rights and obligations

Who should attend
CEO, Compliance Officer, CFO, Revenue Specialist and Anyone Involved In Coding and Billing


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About Our Speaker

David Glaser - Hospital Coding Guidelines Expert

David M. Glaser is a shareholder in Fredrikson & Byron’s Health Law Group. David assists clinics, hospitals, and other healthcare entities negotiate the maze of healthcare regulations, providing advice about risk management, reimbursement, and business planning issues. He has considerable experience in healthcare regulation and litigation, including compliance, criminal and civil fraud investigations, and reimbursement disputes. David’s goal is to explain the government’s enforcement position, and to analyze...   More Info
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