Solve NCCI Edits and MUEs - On-Demand

Available ON-DEMAND

Presented on: Wednesday, January 18, 2023 

Presented by: Denise Williams, COC, CHRI

Medicare’s National Correct Coding Initiative (NCCI) edits and Medically Unlikely Edits (MUE) are a common pain point and a growing concern. As commercial payers increasingly adopt NCCI edits and MUEs, staff can quickly be overwhelmed by the edits’ complexities, interactions, and related payer requirements. A backlog of edits can throw a wrench into the revenue cycle, leading to delayed billing to resolve the edit or even delayed reimbursement if the edit is improperly bypassed and the claim is rejected or denied. Reworking and resubmitting claims creates even more administrative burden and cuts further into an organization’s bottom line.

During this 60-minute webinar, Denise Williams, COC, CHRI, will review the latest updates to the NCCI narrative manual instructions, as well as specific edits organizations see on a regular basis. Williams will discuss strategies for managing edits, avoiding denials, and solving common edit challenges. The presentation will be followed by a live Q&A.

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

• Define NCCI edits and MUEs
• Describe recent updates to the NCCI manual
• Identify strategies for addressing edits and solving root causes 

Agenda

This program will cover:

• What are NCCI edits and MUEs and why do they matter?
  • Overview of NCCI edits
  • Overview of MUEs
  • Impact on billing, coding, and claim submission
• How CMS applies edits
  • Use and purpose
  • Application of NCCI edits and MUEs
  • Disputing edits and requesting a change
• Identifying when an edit may be inappropriate
  • Process for disputing edits
  • Requesting a change to an edit
• NCCI manual updates
  • Chapter-by-chapter revisions
• Strategies to mitigate edits prior to the billing process
  • Root cause analysis
  • Best practices

Who Should Listen?

• HIM directors and managers
• Coding directors and managers
• Coding staff
• Billing staff
• Revenue integrity directors and managers
• Revenue integrity staff
• Revenue cycle directors and managers
• Revenue cycle staff
• Internal auditors
• Denials and appeals staff
• Finance staff
• Reimbursement staff
• Compliance officers
• Compliance staff

Meet the Speaker

Denise Williams, COC, CHRI, is senior vice president of the revenue integrity division and compliance auditor at Revant Solutions in Raleigh, North Carolina. She has more than 35 years of healthcare experience, including a background in multiple areas of nursing. For the past 20 years, Williams has been in the field of coding and reimbursement and has experience performing E/M, OP surgical, ED, and observation coding chart reviews for facility and professional providers based on documentation, compliance, and reimbursement perspectives. She is a recognized chargemaster expert, assisting with all aspects of chargemaster setup and maintenance. She has contributed content for several books and numerous OPPS/APC articles for HCPro and other publishers.

Continuing Education

AAPC
This program has the prior approval of AAPC for 1 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

Ability to claim credits for this webinar expires on: 1/31/2024

AHIMA
This program has been approved for continuing education unit(s) (CEUs) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting of Approved CEUs from AHIMA does not constitute endorsement of the program content or its program provider.

Ability to claim credits for this webinar expires on: 1/16/2024

NAHRI
This program has been approved for 1 continuing education units towards fulfilling the requirements of the Certification in Healthcare Revenue Integrity (CHRI), offered as a service of the National Association of Healthcare Revenue Integrity (NAHRI).

Ability to claim credits for this webinar expires on: 1/17/2024

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 $229 value! 

PLEASE NOTE 
Participation in the webinar is just $229 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.