Monitor Mondays

Responding to Emergency Department Claim Denials

June 17, 2019
Monitor Mondays
Responding to Emergency Department Claim Denials
Chapters
Monitor Mondays
Responding to Emergency Department Claim Denials
Jun 17, 2019
Chuck Buck | Ronald Hirsch, MD | Knicole Emanuel, Esq. | David Glaser, Esq. | Mary Inman Esq. | Dennis Jones | Shannon DeConda | John K. Hall, MD
Most likely your facility has been hit with claim denials for providing emergency department level-of-care coding. Such denials are not new, and in fact, RACmonitor and Monitor Mondays have been reporting about these denials for a number of years.
Show Notes

Most likely your facility has been hit with claim denials for providing emergency department level-of-care coding. Such denials are not new, and in fact, RACmonitor and Monitor Mondays have been reporting about these denials for a number of years. 

But how can you and your team effectively deal with them? What tools and techniques are available? 

During this edition of Monitor Mondays, John K. Hall, MD, founder of The Aegis Firm and the newest member of the RACmonitor editorial board, will make his debut appearance on the broadcast to report on how payers are denying claims and how best to avoid them. 

Other segments to appear during the live broadcast include:

  • RAC Report: Healthcare attorney Knicole Emanuel returns to the broadcast to report on the latest audits by Recovery Audit Contractors (RACs) and other third-party auditors. Emanuel, a member of the RACmonitor editorial board, is a partner in the Potomac Law Group. 

  • False Claims Act Report: The U.S. Attorney’s Office in Chicago announced this week that a Chicago-area physical therapy center and four nursing facilities have agreed to pay $9.7 million to resolve civil allegations that they violated the False Claims Act by providing unnecessary services to increase Medicare payments. The owner of the skilled therapy service provider was excluded from the Medicare program for five years. On hand to explain the significance of this unusual case will be famed whistleblower Mary Inman, partner in the London office of Constantine Cannon. 
     
  • Risky Business: Healthcare attorney David Glaser returns to Monitor Mondays with his popular segment, in which he reports on problematic issues facing providers. 

  • Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will make his Monday Rounds with another installment of his popular segment.


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