Understanding the climate of compliance has become paramount in successfully running a successful practice. As the federal government focuses on finding “fraud and waste,” documentation expectations in both a hospital and private practice environments have taken a new set of rules. This webinar replay focuses on the impact of government and private payor audits and how it relates to evaluation and management services in both an inpatient and outpatient setting. It will also cover audit targets with emphasis on collaborative visits with physicians and NPPs.
- Overview of E/M criteria for new, established, admission, and subsequent visits.
- Discuss the uses of 1995 to 1997 exam guidelines and impact on EMR code checks.
- Learn how time-based services can solidify E/M visits to override criteria.
- Understand the basics of “incident to” and shared services with consideration to regulatory constraints based on place of service.
Jana Gill, Principal, Gill Compliance Solutions, LLC. Jana is a renowned compliance coding professional with a bent for ingenuity and innovation. Mrs. Gill is well regarded for her depth of compliance regulations and performance improvement methodologies using proprietary technology and virtual tools. Her professional successes and 19 years of experience in medical auditing, litigation, and compliance led her to form GCS in 2010. Along with her talented team, Jana also assists health systems and independent clinics with managing internal/external compliance process, government payment audits, RAC risk assessments, and on-boarding due diligence.