Leading you to compliant documentation and appropriate billing
How safe are your payments for hydration therapy and drug administration via infusions and injections? Payers and auditors see rampant noncompliant practices that often warrant claim denials or recoupments. Top issues include incomplete or inaccurate documentation — especially missing time increments and lack of support for medical necessity. Considering how much revenue is generated by these high-volume services, you need to make certain you’re fully supporting your charges and billing appropriately.
Because the stakes are so high, we’ve brought in two top subject matter experts, Robin Miller Zweifel and Tiffani Bouchard, to help you shore up your documentation for hydration therapy, infusions and injections. They’ll also guide you through important considerations when determining whether a service is billable or part of a non-billable “standard of care.” Empowered by this MedLearn Publishing webcast, you’ll be better equipped to prevent errors before payers and auditors are compelled to take corrective action.
- Update on post-payment audits and current Recovery Audit Contractor (RAC) status for hydration therapy
- Minimum documentation requirements for encounters involving hydration therapy and drug administration by injection or infusion
- Keys to the accurate calculation of billable hours based on time, rate and volume for infusions of a fluid, drug or other substance
- A clear understanding of the difference between “medically indicated” and “medically necessary”
- Guidance through common questions and pitfalls, such as why an injection or infusion may not be billable
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A proven leader in revenue cycle management, Robin has a background in proactive audit and documentation reviews for hospitals, independent laboratories, and physicians. Other areas of focus include documentation improvement and charge reconciliation for pharmacy and drug administration performed in Oncology and Specialty Infusion Centers. In 2016, Robin turned her focus toward coding and billing compliance of gene-based testing, including pharmacogenomic tests that may guide determination of effective treatment plans. And in 2021, she joined the Compliance team at BioReference Laboratories as director of coding and billing compliance.
Tiffani Bouchard has more than 25 years of experience in chargemaster management, hospital bill auditing, claims issues resolution and coding and documentation reviews for PPS and CAH hospitals across the country. Tiffani has extensive knowledge of CMS coding and billing requirements, as well as current regulations, and she provides on-site training for chargemaster staff, claims processing staff and department leadership.