Documentation of Medical Necessity - Focus for OIG and other auditors

Why Should You Attend:

This webinar will address the various methods of ensuring appropriate documentation to identify Medical Necessity for services provided.

An area that is often over looked is the significance of the medical coding from Hospitalization to Home Care and the skilled nursing facility between. With the new coding guidelines for ICD-10; our use of documentation is essential, as we are required to support the services we provide with not only the correct coding but the documentation to match the coding.

We will look at how identification of correct coding will allow our nursing, rehab and support staff to correctly document the services provided. By ensuring that the documentation written by your staff matches the Diagnosis selected it will ensure that medical necessity of services is demonstrated. By looking at a how our staff is completing documentation, at the wording used and supportive documentation from all department, we can target areas of weakness in documentation and continue to improve in areas that are functional but not optimal.

All CMS guidelines and regulation are based on the definition of “Medical Necessity” IF the medical need for the services rendered is not present or identified, services can and will be denied. If Nursing relies solely upon therapy to demonstrate medical need of services or vice versa, this creates an opening for the denial of services. When Medical Necessity is demonstrated then services are optimized. When department’s documentation is supportive of the medical necessity of the services being provided, the risk for denial of services is significantly reduced.

Areas Covered in the Webinar:

• How is Medical Necessity Defined
• Documentation needed to demonstrate Medical Necessity
• Rational behind documentation supporting coding
• Necessity for documentation to show progression of medical changes
• Interdepartmental documentation to show medical need for services

Who Will Benefit:

• Healthcare Administrators
• Nursing Directors
• Doctors
• Nurses
• Therapists
• Compliance officers
• Healthcare Policy Experts
• Healthcare Advocates
• Documentation
• Medical Records Clerks
• Rehab Staff
• Managed care service providers

Laura S Hargraves
Independent Business Owner, Bridging Documentation

Laura S Hargraves, MS CCC- SLP RAC-CT, has been working in all aspects of the healthcare industry for the past 28 years. Ms. Hargraves has been providing compliance and oversight of documentation to meeting changing guidelines during this period. She has a background in education, which helps her maximize her ability to communicate these changes to the various professionals that she works with. She is an expert in documentation/compliance/audits and reviews. Ms. Hargraves is also a professional presenter on topics related to Medicare, MDS 3.0, and documentation.

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