Head off Medicare “Not Medically Necessary” Denials and Write Offs

Clear

Getting a Medicare denial for “not medically necessary” services can seem like a slap in the face.

Although Medicare only pays for services it deems “reasonable and medically necessary” it does provide tools to help (i.e. National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs)). The problem is that utilizing NCDs and LCDs correctly isn’t easy, but there is something you can do about it.

Using NCDs and LCDs properly can significantly reduce the number of denials you receive and write offs you process for the “not medical necessary” excuse not to pay you. That’s where expert coder and trainer, Leonta (Lee) Williams, RHIT, CCS, CCDS, CPC, CPCO, CEMC, CHONC, CRC, AAPC Fellow, comes in.

During her online training session, Lee will walk you through how to utilize NCDs and LCDs properly. You’ll be able to significantly reduce the number of denials you receive and write offs you process for the “not medical necessary” excuse.  You’ll learn how to use these complex tools to improve your practice’s overall revenue.

Here are just a few of the proven tactics you’ll be able to master by viewing this online training:

  • Stop noncovered services from leading to patient frustration
  • Reduce CERT errors and get paid for more of the claims you report
  • Uncover hidden NCDs and LCDs errors in your EHR data, file cleaner claims
  • Save time by decreasing appeals for denied services due to “not medically necessary” services
  • Really figure out how to utilize ABN forms to slash your Medicare write offs
  • Get the highest payment by comparing your MACs LCD and the NCD
  • Participate in the “Comment Periods” to get more services approved
  • Pin down when services are considered “not reasonable and necessary,” to avoid huge write offs
  • Add edits to your EHR or lab interface to increase your number of paid claims
  • And so much more…

If you’re receiving denials for services deemed “not medically necessary,” you should watch this session. If you’re writing off charges for services deemed “not medically necessary,” you should watch this session. If you don’t have proper EHR edits in place based on the NCDs and LCDs, you should watch this session.

Arm yourself against these challenging Medicare denials, and finally get paid for more for the services you provide.

Meet Your Expert

Leonta Williams
RHIA, CCS, CCDS, CPC, CPCO, CRC, CEMC, CHONCDirector of Coding

Leonta (Lee) Williams is currently the Director of Coding at a large physician organization in the southeast.  Lee has over 15 years of experience working in both the outpatient and inpatient setting.  Some of her professional roles have included coder, auditor, practice manager, educator, and trainer.

Lee has presented at national healthcare conferences, private healthcare training organizations, and has frequently contributed articles to healthcare publications.  She currently serves on a number of Boards including Georgia Health Information Management Association (GHIMA) and the American Academy of Professional Coders (AAPC).  Lee has a B.S. in Health Information Management and an MBA with concentration in Healthcare Administration.

Reviews

Informative.
Melody Moore
Billing Manager, Mission Neighborhood Health Center