Strategies for Implementing Internal Coding Audits and Addressing Payer Audits

Strategies for Implementing Internal Coding Audits and Addressing Payer Audits Webinar In an effort to control costs, third party payer claims processing and Special Investigative Units (SIU) are conducting audits of claims to prevent improper payments and overpayments. Pediatricians, practice management, and coding staff need to be prepared to protect the practice from payer audits as well as be able to challenge audit results. Otherwise, faced with unstable revenue, potential fines, and liability, the viability of the pediatric practice will be threatened. This 60-minute webinar will provide guidance on ways to minimize the risk of a payer audit as well ways to effectively challenge payer audit results. By the end of the webinar, participants will: Apply key steps in responding to payer audits Apply appropriate documentation Learn how to include key provisions in contracts that protect the practice and define the scope of payer audits and follow up activities Learn tips to minimize payer audits Learn tips to implement internal auditsAbout the Presenter: Richard Lander, MD, FAAP, is a managing partner in a four- person pediatric private practice in New Jersey. He attended the University of Cincinnati, received his M.D. from the Autonomous University of Guadalajara, Mexico, and completed his pediatric residency at the University of Medicine and Dentistry of New Jersey where he served as chief resident. He is currently a Clinical Professor of Pediatrics at UMDNJ. As the President of the NJ-AAP Chapter, he initiated and remains as co-chair of the Pediatric Council that has met quarterly over the past five years with the medical directors who serve the New Jersey area. Nationally, Richard serves on the AAP Section on Administration and Practice Management (SOAPM) as immediate past chairperson, served on the Committee on Child Health Financing, and is SOAPM's representative to the Private Payer Advocacy Advisory Committee (PPAAC). In addition, he represents the AAP on the MinuteClinic, Inc. quality advisory panel. Since 1989, he has been an AAP Regional CPT Trainer and has lectured on coding and practice management for the AAP, private enterprises, and Pediatric Residency Programs. He serves on and contributes to several coding newsletter editorial boards.