The ADR to Appeal Primer  Webinar Series

This lighter version of the appeals process helps you gain peace of mind by learning what reviewers seek and how to respond to reviews. QIRT compliance expert, Joe Osentoski, brings together knowledge of the multiple types of medical reviews, how the responses are different, how to identify and handle denials, and appeals options and actions.

This lighter version of the appeals process discussion brings together knowledge of the multiple types of medical reviews (ADRs, Probe, ZPIC/UPIC, RAC, CERT), how the responses are different, how to identify and handle denials, and appeals options and actions. Join us as Joe Osentoski, RN, discusses much more on the review (ADR) process so that agencies are aware of the risks of each type of review.   

The ADR to Appeal Primer, Part I

   October 12, 1pm EST - $99

1. Why reviews are occurring
2. Who is doing reviews
3. Differences between reviewers
4. OIG "red flags" for review
5. Types of reviews: ADRs, probes, audits
6. Current CMS focus: Targeted Probe & Educate
7. ADR requests from MAC/ZPIC/UPIC/RAC/CERT
8. Responding to an ADR
9. Probes and Results

The ADR to Appeal Primer, Part II

   October 13, 1pm EST - $99

1. Current denial trends
2. Reading a denial
3. Targeted Medical Review
4. Appeals (Level 1 and Level 2)
5. ALJ hearing preparation, attendance
6. Financial concerns: extrapolation, recoupment
7. Compliant charting
8. Face to face requirements