Description: Do you have questions about Medicare Part A or Part B rejections, denials, or appeals?  Join the WPS Provider Outreach and Education team to review the most common Medicare denials or rejections in Indiana and tips to avoid these.

Session Description

Join the WPS Provider Outreach and Education team to review the latest and most common Medicare denials or rejections in Indiana for Part A and Part B providers and tips to avoid these.  In this session we will review the following topics:

• Overview of data and statistics for top rejections and denials for Part A and Part B Indiana providers
• Tips for fixing rejections and how to remedy denials
• Overview of Part A reopening process
• Overview of Part B clerical error reopening process
• Review of the appeals process focusing on Part A and Part B specific processes
• CMS provider initiatives including provider depression screening and Cognitive Assessment & Care Plan utilization
• Other CMS and WPS things you need to know

We will conclude with a question-and-answer session. Hope to see you there!

Webinar Date: This was presented as part of IHIMA’s 2022 Virtual Annual Meeting – April 2022

Duration: 1 hour

Speaker: Rachel Wood, MSN, has a Bachelor of Science in Nursing (RN/BSN) from West Chester University in West Chester, PA. She has a Master of Science in Nursing (MSN) focusing on Nursing Informatics from the University of Maryland, Baltimore.

Her Medicare experience began in 2015. She began working with Medicare in 2017 and joined our team in 2021. She provides clinical education to WPS affiliates throughout the US.

Before joining us, she worked in the Utilization Management department at Independence Blue Cross in Philadelphia, PA. Her responsibilities included:

• Reviewing Prior Authorizations for chemotherapy and other high-cost medication requests for Medicare and Commercial members
• Quality improvement projects

Prior to working in health insurance and Medicare, Rachel practiced clinically at Johns Hopkins Hospital as a psychiatric nurse. She specialized in the treatment of eating disorders.

Speaker: Mary E. Muchow is a Specialist in Provider Outreach & Education (POE) and has over 40 years of experience with WPS GHA. Mary has held progressively responsible positions in Claims Examination and Entry, Medical Review, and Training. Prior to joining the POE team, Mary spent several years working in the Benefit Integrity Unit as an investigator and trainer for other staff. Later, as the Medicare Fraud Information Specialist(MFIS), Mary represented multiple Centers for Medicare & Medicaid Services (CMS) contractors as a liaison between federal investigators, prosecutors, CMS, and other agencies. In her MFIS role, Mary often presented relevant Medicare fraud and abuse topics to law enforcement and audiences on a national level.

Mary joined the POE team in 2003. She enjoys supporting and providing outreach activities that meet CMS requirements relative to provider education, including the development of professional and productive provider partnerships with various societies and associations. She also serves as a member of CMS’ Medicare Learning Network (MLN) National Provider Education Workgroup.

Click HERE to register for this webinar!

Cost: FREE!

Domain: Revenue Cycle Management