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The Voice of Acupuncture and Traditional East Asian Medicine in Colorado

Bulletproof Insurance Billing, Exams and Documentation with Mori West

  • 12 Dec 2020
  • 9:00 AM
  • 13 Dec 2020
  • 4:30 PM
  • Online

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Bulletproof Insurance Billing, Exams and Documentation

Join the AAC for updated insurance billing, exams and documentation for 2021!

December 12 & 13

16 CEUS approved for NCCAOM and CA

9am-430pm (all recordings will be available for 60 days)

Price for AAC/WAS Members (extended) until Nov 24:  $180 for early bird members, then $190 for AAC members til 12/12.  (non-members $290/$320)

Both days will be useful for both newbies and seasoned providers to insurance.

- Day One will cover basic terminology, changes to medicare and VA, as well as updated CPT codes and tele-health. (see below for full schedule)

- Day Two will cover specific laws in Colorado and how to make your exams/documentation bulletproof. (see below for full schedule)

We are encouraging participants to take both days since recordings will be available and new updated information will be covered in both days.  The AAC is very excited to offer this discount to our members to help patients access and our practices thrive.

Pricing:

Both Days: 

Non-members: $320, earlybird - $290 (til Nov 20)

AAC/WAS members (40% discount): $190, earlybird - $180 (til Nov 20)

One Day: Beginning Billing or Bulletproof Exams and Documentation

Non-members: $210

AAC/WAS members (40% discount): $110

Students:

Both days: $100

One days: $50

Schedule:

Day 1 – Beginning Billing 

  • 1.      Insurance Basics - It’s the basics- what is a deductible, a copay, an EOB, PPOs, HMOs, POS etc. We’ve got to start with a baseline so all students have a good understanding of the basics and language.
  • 2.     Networks and Network Participation - Starting with CAQH, which networks you can join in CO and general info about payment
  • 3.     Medicare - I’ll explain the new 1/21/20 policy and the affects it had on other carriers.  We’ll talk about the supervision requirement and I’m introducing a form that can be used to reimburse the Medicare patient, so you can treat cLBP without any supervision.  We’ll talk about Medicare rates.
  • 4.     VA CCN program - I’ll explain how to join, explain AUTH’s and SEOCs and the fact that they are authorizing 2 units, but based on their own policies they should be authorizing 3.  How Triwest “misinterpreted” how to process claims and in many cases are recouping when they shouldn’t be and what you should do about it.  I’ll include responses we have received from the VA.
  • 5.     CPT Codes - Explain what CPT codes are used by acupuncturists.  I’ll talk about the new DN/TPA codes and how acupuncturists now have a seat at the AMA CPT code meetings.  The new codes for PPE reimbursement.  E/M coding and when you bill for them.
  • 6.     ICD10 Codes - I’ll explain dx coding and how to code for chronic.  Why you shouldn’t use unspecified codes.  A new code for headaches.
  • 7.     Claim Forms and sending Electronically - I’ll explain which boxes should have info, and what is better left blank.  I’ll give examples of reg claims, WC claims, PI claims and how resubmit a claim.  How to do it all electronically and the use of a clearinghouse.  I go over Office Ally.
  • 8.     Verification - THE important first step.  I’ll explain what questions to ask and why and provide a sample form to use.
  • 9.     Telehealth Coding - Which codes and modifiers to use.  Updates from carriers on telehealth.
  • 10.  Best practices in the office - Privacy practices, Hipaa, etc.

I also provide plenty of handouts.  Cheat sheets for coding CPT and ICD10, pre-filled forms for various types of insurance.  Additional links to resources. 

Day 2 – Bulletproof Exams and Documentation

  • 1.      Review of Coding - A deeper dive into E/M coding, understanding the requirements, review of timed based procedures.
  • 2.     Exams that Establish Medical Necessity - We go over what you should be doing when you do your exam.  Review of systems associated with the Chief Complaint.  Signs and tests to do and look out for.  How to assess ROMs from the top to the bottom.  How you can use percentages instead of degrees.  How to write your notes and abbreviations.
  • 3.     Documentation & Coding - We put it all together so your exam findings, your treatment plan all show the medical necessity of your treatments.  What you must have in your notes to be on the same level as all other healthcare providers.  How to document timed based procedures.
  • 4.     What Carriers are looking for - I spell it out by showing audit results from various carriers.  We discuss Outcome assessment tests and how to score.  Why ADLs and examination findings are so important.  It’s MORE than just the pain scale.  If you can prove medical necessity carriers HAVE to pay your claims.
  • 5.      Laws in your state - How misrepresentation laws help you win appeals.  How much to charge when you get asked for notes and timelines for recoupment by carriers.
  • 6.     Appeals - I explain how to win appeals using misrepresentation laws and the process to appeal claims that have been denied.  I’ll show actual appeals that got providers paid.  In one case the patient had NO acupuncture benefits.
  • We’ve developed a Simple Exam Quick Reference Guide as well as a cheat sheet on E/M guidelines which include HPI, Palpation guidelines and pain frequencies.  Sample progress notes and sample letters of medical necessity are also included.


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