Tag Archives: sharon easterling

“Finally Friday!” Strategies for Medicare Level 3 Appeals

FRIDAY October 17, 2014 Medicare Appeals at Level 3: Providers Left in the Lurch Veteran Appeals Attorneys Review Recent Experiences with ALJs How Can You Prepare & Respond? Watch the Replay and Get the Handouts Since CMS began re-educating the … Continue reading

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“Finally Friday!” Solutions to RAC ADRs, Global Settlement Offer

FRIDAY September 26, 2014 Solutions to Recent CMS Initiatives How Some Providers Address Them Get the Handouts One thing’s for sure… it’s not boring around here, is it? This week we’ll cover two key subjects and the re-appearance of RAC … Continue reading

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“Finally Friday!” Final Word on Transmittal 541 and “Clawbacks”

FRIDAY September 19, 2014 The Final Word on “Clawbacks” Transmittal 505/534/540/541 Watch the Replay and Get the Handouts Project FAIL: when a government project fails, they just change it’s mission – reset the parameters, the expectations. That’s what happened with … Continue reading

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“Finally Friday!” CMS Global Settlement Offer for Existing Appeals of Inpatient Claims

CMS Offers 68% for Your Appeals: How will it work and is it a good deal ? Get the Handouts Late on Friday August 29, 2014, CMS issued proposed settlement terms to acute care hospitals with pending appeals of denials … Continue reading

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“Finally Friday!” Can You Use Condition Code 44?

The Proper Use of Condition Code 44 – Converting IP to OP with a *NEW* Decision Tree Plus More Scenarios from Dr. Pahuja Watch the Replay and Get the Handouts We’ve recently heard reports that there are many hospitals using … Continue reading

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“Finally Friday!” Decision Trees for 2-Midnight Rule Conversions

Joining us this week was a panel of experts discussing our handouts, decision trees for: Day One Day Two Day Three & Beyond Conversion of OP to IP Find the PDFs below – download and post, copy, distribute, whatever – … Continue reading

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“Finally Friday!” Leveraging Technology for UR Best Practices

This session was broadcast on Friday, June 6, 2014. Clare Cermak, Implementation Training Consultant at Allscripts, teaches you the best ways she’s seen for how you can: Organize, Prioritize and Managing your day (Includes worklist functionality, flagging 2-Midnight Rule, Orders Verified, Next Review Date) … Continue reading

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“Finally Friday!” MAC Probes, AHA Lawsuits, and OIG Reports on E/M

Bill Malm of Craneware reviews some new OIG Reports, foreshadowing perhaps a flood of E/M Audits by CMS contractors. We also hear from Dr. Ron Hirsch of Accretive PAS about some of the insanity coming out of the MACs in Probe and Educate. Jessica Gustafson and Abby Pendleton from The Health Law Partners give us some legal perspective on the OIG postings, and a short review of the recent AHA filing of a mandamus complaint – a filing seeking a judicial remedy to require CMS to “meet statutory deadlines for administrative review of denials” for Medicare claims. Continue reading

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