Attention:
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Medical Coding and Billing 202


Level: Intermediate
Runtime: 91 minutes
Recorded Date: March 01, 2018
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Agenda

12:00 pm - 1:30 pm
  • Understanding the CPT Book
  • Evaluation and Management coding guidelines
  • Local Coverage Determinations Presenting medical documentation in appeals
  • Applying documentation requirements in voluntary refunds
Runtime: 1 hour and 31 minutes
Recorded: March 1, 2018

Description

What is a “chief complaint,” and how is it related to my client’s Medicare audit? Where do I find documentation guidelines for hyaluronan injections so I can figure out if my client should have been paid? What does complexity of medical decision-making involve, anyway?

Lawyers defending clients in payor audits or assisting clients with voluntary refunds need a practical understanding of the sources and substance of documentation guidelines for medical services. These documentation requirements are the building blocks of an audit defense, and are the key guidelines for determining whether a voluntary refund is required.

This program was recorded on March 1st, 2018.

Provided By

American Bar Association
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Panelists

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Patrice Morin-Resch

Chief Operating Officer (COO)
Physicians Fee Analytics

Patrice Morin-Resch is an author, teacher, usual and customary fees analyst, and medical coding and reimbursement expert with over 30 years of experience.

Ms. Morin-Resch began her profession as an editor of the CPT book for the AMA and answered literally thousands of questions on medical coding and the proper use of the codes found in the CPT book. From there, her career advanced to teaching over 35,000 people both in private and open seminars through the DoD, various insurance companies (both health insurers and vehicle insurers), medical associations (e.g., Minnesota Medical, Texas Medical and Minnesota Hospital, ASOA), CPA firms, private practices and clinics as well as to publishing how-to books on medical coding.

Ms. Morin-Resch now maintains over 50 copyrights for books on medical coding. Her primary text, cp "Teach" Expert Coding Made Easy! has been awarded both the esteemed McGuffey (2011) and Texty (2013) awards through the Text and Academic Authors Association.

In 2012, Body Works, a book she co-authored with John Brady, M.D., Ph.D., was granted the prestigious Ben Franklin Award through the Independent Book Publishers Association.

As a distinguished author in her field, Ms. Morin-Resch was appointed to the TAA Council of Fellows, an honor held by fewer than 50 people worldwide. Because of the fact that Ms. Morin-Resch is primarily a teacher, she is skilled at breaking down the subject of coding in a way that makes it easy to comprehend. She has helped lawyers, doctors, jurors, and judges understand the CPT rules in such a way that they understand the facts of the case and are able to make sound decisions/rulings.

Ms. Morin-Resch maintains her CPC, CMCS, CHCI and CPMA* certifications through the AAPC and PAHCS and is an active member in both groups. She is fluent in both English and Spanish. (* The CPMA certification is held by only 3% of all members of the AAPC.)

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Sean A. Timmons

Shareholder
Polsinelli, LLP

In order to craft an effective legal strategy to assist clients in reaching their business goals, Sean Timmons draws on a wealth of practical experience and solid understanding of the health care industry, coupled with a firm grasp of substantive law in this highly regulated environment.

Sean advises clients on complex regulatory issues including compliance with federal and state fraud and abuse laws and regulations. He has defended clients in Medicare and Medicaid administrative proceedings and has assisted clients in responding to and negotiating resolutions of government investigations into Medicare and Medicaid billing practices. He has commonly assisted clients on acquisitions and joint ventures involving healthcare entities, including advising clients on the application of the federal health care program’s anti-kickback statute and federal physician self-referral (or “Stark”) statute.


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