Overview: Recovery audits of all types have increased to such a degree that they are now more of the rule than the exception. When you consider government program such as CERT, HEAT, RAC, ZPIC, MIC, MAC, OIG and then factor in private payer audits and recoupments, it begins to feel more like a war zone than a healthcare organization. The practice has two distinct opportunities at their disposal; pre-audit risk assessment and the post-audit risk mitigation. The pre-audit risk assessment involves analyzing the utilization of your codes and modifiers against a variety of internal and external benchmarks.
Why should you attend: In this session, Frank Cohen, statistician and risk analyst, will look at the teach you how to assess your compliance risk by comparing procedure code, RVU and modifier use against peer statistics to assess the relative risk of being audited by either CMS or your private payers. Additional risk metrics reviewed will include time and utilization per patient per unit of time.
Areas Covered in the Session:
Learn about the different types of recovery audits
Understand how the CERT study impacts audit risk
Create utilization tables from your own data
Identifying which code/modifier sets are most at risk
Appreciate the value that analytics play in risk assessment
Hear how others have reduced risk through case examples
Who Will Benefit:
Chief Compliance Officer
Director of Compliance
Frank D.Cohen is the Director of Analytics and Business Intelligence for Doctors Management, a Knoxville-based healthcare consulting firm. His areas of expertise include applied statistics, data mining, predictive analytics and process improvement.
contact no: 800-385-1607
fax no: 302-288-6884