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Office Trainings
Your Official Training Partner
Live Webinar

Eligibility, Prior Authorization, and Medical Necessity: 2021 Updates
 
Don’t Delay, Register Today and SAVE $50 - Use Code "OT50" at check-out
Presented by: Lynn M. Anderanin
Date: September 9, 2021 | Time: 1 PM ET | Duration: 60 Min

Register Now!

In an effort to manage healthcare costs insurance companies have several
programs that need to be addressed to ensure a claim will be paid, but with
still no guarantee. Many services require authorization to be obtained before
services and procedures are performed. Insurance companies are constantly
changing their prior-authorization requirements. It is also common that
employers will change insurance plans to save money on monthly premiums. This
webinar will walk through how offices can obtain eligibility before the patients
are seen to confirm that the insurance information that is available is accurate
and the patient is covered for services to be rendered. Then when the patient is
seen, any services or procedures that are ordered may need to be prior
authorized for that reimbursement will be received.
 
The final piece is that the medical necessity requirements for the procedure or
service is being met according to insurance company policies and guidelines.
Attendees will benefit from this webinar in that we will discuss all of these
aspects of a medical claim that may have to occur before the insurance company
even processes it and will reduce the number of claims an office can receive
because these steps were not taken. This session will address the differences
between eligibility, prior-authorization, and medical necessity and give
attendees the steps needed to help ensure that claims will be submitted to the
correct insurance company with the requirements of the insurance company met
based on guidelines and policies set by the insurance company.
 
Webinar Objectives:
 
When a patient presents an insurance card proving medical coverage this is not
guarantee that all services and procedures will be reimbursed by the insurance
company. It is up to the office to confirm eligibility for the date services are
rendered, obtain prior authorization for those services and procedures the
insurance company requires to be pre-authorized, and to have knowledge of the
specific insurance company’s policies on medical necessity for the services and
procedures performed. Knowing and understanding each of these elements will
allow a more successful and timely turnaround for claims reimbursement.
 
Webinar Agenda:
 * Methods of obtaining patient eligibility
 * Information received from eligibility
 * Medicare options to patients
 * When Prior Authorization is necessary
 * Tricks to receiving authorization for coding options
 * Major insurance carrier information for eligibility and prior authorization
 * How to determine medical necessity
 * Interpreting insurance carrier policies
 * Managing claims denials
 * Writing effective appeals

Register Now!

Don't Delay, Register Today and Save $50 - Use Code "OT50" at check-out For
group discounts email us at contact@officetrainings.com or call us at +1
847-268-3838 About Speaker: Lynn Anderanin, CPC, CPPM, CPMA, CPC-I, COSC, has
over 35 years’ experience in all areas of the physician practice, specializing
in Orthopedics. Lynn is currently a Workshop and Audio Presenter. She is a
former member of the American Academy of Professional Coders (AAPC) National
Advisory Board, as well as several other boards for the AAPC. She is also the
founder of her Local Chapter of the AAPC...Read More Office Trainings, 101
Clearview Pkwy, Metairie, LA, 70001, USA

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