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OVERVIEW

Acute care hospitals are revitalizing their audit practices as it relates to Medicare Advantage (MA), also known as Medicare Managed Care, denials more than ever. Across the industry we’re seeing headlines and common challenges that demonstrate opportunity for improvement to ensure MA patients have access to medically necessary care and providers are paid accurately.

McBee expert, Shirley Vazquez, will dive into current audit practices and trends your organization should be aware of in 2022. In addition, we will review federal and state regulations and differences in contracted vs. non-contracted MA plans.

LEARNING OBJECTIVES

  • Understand and review both CMS and State requirements
  • Analyze different types of denials, including medical necessity vs. DRG downgrades
  • Discover audit trends, best practices to follow, and strategies to combat denials moving forward

SPEAKER

Impacts of PDGM Webinar

Shirley Vazquez
Senior Manager, Denials Management