Description: This presentation focuses on current denial trends including helping to understand steps that can be taken on the front end to help prevent denials. It will also help to identify query opportunities to obtain documentation that will help win appeals.

The presentation will help you to read the ICD-10-CM Official Guidelines for Coding and Reporting in a new way including focusing on what is meant by the language used in the Guidelines. It will also provide a better understanding of the role that AHA Coding Clinic can play in helping to win appeals. 

Webinar Date: This was presented as part of IHIMA’s 2024 Annual Meeting & Exhibit – April 2024 

Duration: 1 hour

Speaker: Michelle Barrett, Attorney at Law, RN is currently a Clinical Validation Appeals Specialist at Mayo Clinic. Since September of 2018, she has been instrumental in starting Mayo Clinic’s robust clinical validation appeals program from the ground up. She came to Mayo Clinic as a contract Clinical Documentation Integrity Specialist through CDI MD in April of this 2018 and worked with CDI on the Phoenix, Arizona Campus until she transitioned to the appeal role. She has worked as a CDIS since 2010 including 8 years at Wishard/Eskenazi Health in Indianapolis, IN. Michelle currently works on a variety of appeals including high dollar, Claim Payment Integrity Reviews, National Coverage Determination, coding/RAC and clinical validation. She also participates in peer-to-peer conversations, State Fair Hearings and Administrative Law Judge Hearings.

Michelle is admitted to practice law in good standing in the States of Indiana and Texas with her Texas law license currently being inactive. She is licensed as a registered nurse in the State of Indiana. She has worked in a variety of roles as a registered nurse and a practicing attorney.

At Eskenazi/Wishard, in addition to completing medical record documentation reviews, she performed second level and above payer denial appeals for medical necessity and clinical validation including providing expert medical testimony at Administrative Law Judge hearings when necessary.

She has participated in Medicaid Chart Audits for the State of Virginia. In addition, she worked in Quality and Safety at St. Vincent helping to ensure compliance with CMS, Joint Commission and State Department of Health Standards.

As an attorney she has practiced as a Deputy Prosecutor in the areas of child support and paternity including seeking reimbursement of Medicaid dollars paid for the birth of the child. She has also worked in private practice in the areas of family law and medical malpractice. She has tried multiple cases and been a presenter in multiple settings during her years of practice both as a registered nurse and an attorney.

Michelle received a BS from Purdue in 1982, JD from IU School of Law in 1985 and an ASN from IU School of Nursing with highest distinction in 2003.

Click HERE to register for this webinar!

Cost: $25 Members/ $35 Non-Members

1 AHIMA CEU*

Domain VIII: Evolving Topics/Other HIIM Relevant Topics

*AHIMA CEUs are also accepted by the AAPC. Check eligibility on the AAPC website.