Clearing the Air: Evaluating Oxygen Coverage with Medical Records
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$149.00
$149.00
per item
Recorded on: March 16, 2017
Recorded by: Andrea Stark - Reimbursement Consultant
True or False? Obtaining a proper oxygen test documenting saturation levels below 89% qualifies a patient for Medicare coverage of oxygen therapy.
How about less than 80%? 8%?
False, false, and false.
While we can certainly agree that those results suggest a dire need for intervention, there is a big difference between clinical need and eligibility for reimbursement. In fact, testing is not, and never has been, enough to justify oxygen reimbursement.
And so, it is simply not enough to train customer service representatives (CSRs) to obtain test results before setting up a new patient. They must identify details such as diagnosis, severity, and treatment history in the medical records to effectively predict a coverage decision. This session is not about second-guessing physicians’ directives; it is about reconciling those decisions with coverage.
Invite your CSRs, billing specialists, and marketing staff. Attendees to this event will learn to:
Recorded by: Andrea Stark - Reimbursement Consultant
True or False? Obtaining a proper oxygen test documenting saturation levels below 89% qualifies a patient for Medicare coverage of oxygen therapy.
How about less than 80%? 8%?
False, false, and false.
While we can certainly agree that those results suggest a dire need for intervention, there is a big difference between clinical need and eligibility for reimbursement. In fact, testing is not, and never has been, enough to justify oxygen reimbursement.
And so, it is simply not enough to train customer service representatives (CSRs) to obtain test results before setting up a new patient. They must identify details such as diagnosis, severity, and treatment history in the medical records to effectively predict a coverage decision. This session is not about second-guessing physicians’ directives; it is about reconciling those decisions with coverage.
Invite your CSRs, billing specialists, and marketing staff. Attendees to this event will learn to:
- Evaluate medical records for critical elements that support coverage before patient setup.
- Discern the difference between clinical need and insurance coverage requirements.
- Avoid lost revenue due to bad habits, common policy misunderstanding, and insufficient staff training.
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Add these events to your cart before checkout:
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First Time's a Charm: Passing Audits without Appeals
Medicare Appeals: New Initiatives Make Process Relevant Again