Resolving Coding Disputes: Analyzing Agreements, Identifying Code Standards, Leveraging Expert Opinions
Robert E. Wanerman, Member of the Firm, will co-present "Resolving Coding Disputes: Analyzing Agreements, Identifying Code Standards, Leveraging Expert Opinions," a live CLE webinar hosted by Strafford.
This CLE webinar will guide healthcare counsel on resolving coding disputes. The panel will examine identifying code standards through analysis of provider agreements, manuals, and policies. The panel will discuss working with coding experts as well as issue spotting in the opposition's position. The panel will offer best practices for resolving coding disputes.
Healthcare providers strive to make coding decisions accurately, and payers work for the same when reviewing those decisions. Despite these efforts, disputes arise when those decisions must be substantiated and during the audit process. Both healthcare providers and payers turn to healthcare counsel and experts to resolve disputes over the coding of physician services and supplies.
One of the challenges of coding is the lack of consistently applied code selection rules. The inconsistency makes it difficult to determine if a particular code is right for certain services. This is true for providers and payers and often results in substantive disputes between the two. In addition, to identify the correct code to use, it is prudent for counsel to evaluate the opposing side's position as to code selection.
The panel will discuss identifying code standards by analyzing provider agreements, manuals, policies, or regulatory provisions and working with coding experts and ensuring their opinions are correctly supported. The panel will also address issue spotting in the opposition's position by identifying uncited binding code selection standards. The panel will offer best practices for resolving coding disputes.
- How can healthcare counsel use analysis of provider agreements, provider manuals, or regulatory provisions to identify whether the correct code standards are used?
- What steps should counsel take to identify the appropriate coding standard and rules?
- What best practices should counsel for healthcare providers and payers use to resolve coding disputes?
For more information, please visit StraffordPub.com.