SNF Billing: Managing Managed Care

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SNF Billing: Managing Managed Care

Product Code: YLHA120721A

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SNF Billing: Managing Managed Care

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Presented on:  Tuesday, December 7, 2021 | 1:00–2:00 p.m. Eastern

Presented by: Maureen McCarthy, RN, BS, RAC-MT, QCP-MT, DNS-MT, RAC-MTA

SNFs are realizing reduced reimbursement year-over-year with commercial insurers managing Medicare and Medicaid programs. At the same time, managed Medicare has consumed 30% of the Medicare population and is anticipated to grow exponentially through 2030. Expert speaker Maureen McCarthy, RN, BS, RAC-MT, QCP-MT, DNS-MT, RAC-MTA, will discuss how to defend your facility against payment denials for managed care. Participants will learn how to ensure a robust medical review process and push back against unfounded denials with regulatory language.

Plus, this webinar includes the following take-home tool: CMS Memo for MDS Requirements for Managed Care-covered residents

At the conclusion of this program, participants will be able to:

  • Recognize payment denials based on incorrect interpretation of CMS regulations
  • Locate various SNF regulations governing reimbursement
  • Implement a robust medical review process
  • Manage role assignment for team members with responsibility in the review process

Agenda

  • Understanding managed care’s effect
  • The regulations governing reimbursement and how they can support facilities
  • Looking at improving the medical review process to defend reimbursement
  • Top five reasons for payment denials related to insurers

Who Should Listen?

  • Administrators
  • Billers
  • Clinical reimbursement department staff
  • Directors of nursing and other department directors
  • Rehab staff

Meet the Speaker

Maureen McCarthyMaureen McCarthy, RN, BS, RAC-MT, QCP-MT, DNS-MT, RAC-MTA, is the president of Celtic Consulting, LLC, in Torrington, Connecticut, and the CEO and founder of Care Transitions, LLP, a post-discharge care management service provider. Recognized as an industry leader in clinical reimbursement for long-term care, she has been a registered nurse for over 30 years with experience as an MDS coordinator, director of nursing, rehab director, and Medicare biller. McCarthy and her associates at Celtic Consulting regularly provide consultation focusing on Five-Star quality improvement programs, quality auditing, clinical care management, PDPM/PPS/MDS/CMI services, and compliance solutions including Medicare compliance auditing and custom education.

Instructions

Webinar system requirements and program materials: 
To fully benefit from the webinar experience, please note you will need a computer equipped with the following:

Browser: Microsoft Internet Explorer or Edge, Firefox, Chrome, or Safari, with JavaScript enabled 
Internet: Internet connection (high-speed connection recommended) 
Streaming: Access audio/video streaming from any browser on a computer, mobile, or tablet device

Prior to the webinar, you will receive an email with detailed system requirements, your login information, presentation slides, and other materials that you can print and distribute to all attendees at your location. 

CAN'T LISTEN LIVE? 
No problem. The On-Demand version will be available. Use it as a training tool at your convenience—whenever your new or existing staff need a refresher or need to understand a new concept. Play it once or dozens of times. A $149 value! 

PLEASE NOTE 
Participation in the webinar is just $149 per site. All materials must be retrieved from the Internet. 

Call your customer service representative toll-free 800-650-6787 or email customerservice@hcpro.com if you have questions.