NGS Trends in Medical Review and How to Prepare Your ADRs

• Attendees will learn the most common reasons medical reviewers deny claims submitted by California hospices.
• Participants will recognize their own patient-record vulnerabilities and how to avoid claim denials for the most common reasons.
• Engaged learners will be ready to prepare patient records for ADR response according to medical reviewer preferences, increasing the chance of reviewers finding everything needed to identify payable claims rather than denying payment for claims.

Meeting the Presenter:

Beth is a former Medicare Administrative Contractor medical reviewer. She served on the Hospice Quality Subcommittee for The National Alliance for Care at Home and NACH’s Hospice Advisory and Advocacy Boards as well as CGS’ Hospice and Home Health Provider Outreach and Education (POE) Advisory Groups, and was Executive Director of Utah’s Hospice and Palliative Care Organization and the Utah Association for Home Care when the entities combined into one under her leadership. She has presented for conferences nationwide and teaches her own expert seminars, workshops and webinars. She’s audited records, worked on claims appeals and taught about regulatory compliance for consulting groups and individual agencies throughout the country. Beth edited and wrote study guides and questions for industry coding and compliance certification exams for AHCC and for CHAP, published in Diagnosis Coding Pro and The Rowan Report, and edited a diagnosis-coding manual. Beth is now the Education Specialist for CHAPCA and enjoys working with the hospice and home-health community in California.

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