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Practice Management (PM)

LM404 - Decoding the Future: Trends in Credentialing and Billing Codes

Saturday, April 22, 2023
8:00 AM – 9:00 AM PDT
Location: Tahoma 3 ** 800 Pike
Earn 0.1 CEUs
Tier 1

    Lead Presenter(s)

  • Debra J. Abel, AuD

    Manager, Coding and Contracting
    Audigy
    Vancouver, Washington

    Financial Disclosures: I do not have any relevant financial relationships with anything to disclose.
    Non-Financial Disclosures: I do not have any relevant non-financial relationships with anything to disclose.

    PDF Slides

    • Presenter(s)

  • Jennifer Grudi

    Credentialing Specialist
    Audigy
    Vancouver, Washington

    Financial Disclosures: I do not have any relevant financial relationships with anything to disclose.
    Non-Financial Disclosures: I do not have any relevant non-financial relationships with anything to disclose.

    • Contributor (Not Presenting)(s)

  • CA

    Catie Alford

    Financial Disclosures: I do not have any relevant financial relationships with anything to disclose.
    Non-Financial Disclosures: I do not have any relevant non-financial relationships with anything to disclose.

    • Contributor(s)

  • Jennifer Grudi

    Credentialing Specialist
    Audigy
    Vancouver, Washington

    Financial Disclosures: I do not have any relevant financial relationships with anything to disclose.
    Non-Financial Disclosures: I do not have any relevant non-financial relationships with anything to disclose.

Abstract:
There are several moving parts when participating with insurance companies that include credentialing, coding and appropriate billing. This session will discuss the higher level how to’s of credentialing, information and documentation needed, and coding, the vehicle to reimbursement. In addition, we’ll offer common coding scenarios to avoid for your own billing processes.

Summary:
The world of credentialing and billing is ever-changing. This course will help participants navigate the several moving parts of working with insurance companies. First, we’ll review the two-step process of becoming an in-network provider with commercial insurances. Participants will understand the timeline associated with each step.

Next, we’ll dive into the various pathways to completing credentialing – online, state-specific application and insurance carrier-specific application. Participants will be able to describe what information and documents are needed to complete credentialing.

This course also covers the current trends in billing codes and coding considerations. Participants will learn how to avoid common coding mistakes, understand the newest codes, and how to code for comorbidities.

Lastly, we will discuss the future of reimbursement and how to prepare your practice for success. This section will include information about the Medicare Access and CHIP Reauthorization Act (MACRA) 2015, Medicare Part B changes and MIPS/APMS.

Learning Objectives:

  • Upon completion, attendees will be able to identify documentation needed for credentialing.
  • Upon completion, attendees will be able to describe common AUD coding errors.
  • Upon completion, attendees will be able to apply billing and coding trends in Medicare part B for success in the future.