In recent years, third-party payers began changing their payment models to reflect value-based criteria. Under these payment models, healthcare providers must demonstrate high levels of quality care, efficiency and effectiveness. A key component of achieving these requirements is medical necessity.
In this 90-minute webinar, the audience will learn how the role of medical necessity impacts coding/billing and why it is critical to the continued success of the practice under value-based payment systems. In addition, common documentation errors will be discussed with suggestions for improvement. By understanding medical necessity, OMS offices are more likely to create documentation policies and procedures that will help establish optimal payment and proper compliance.
At the conclusion of this program, participants should be able to:
1. Cite the difference between medically necessary and unnecessary care.
2. Define medical necessity.
3. Discuss the role of medical necessity in value-based payment models.
4. Identify general documentation guidelines that help establish medical necessity.
5. Locate common E/M documentation errors.
6. Report common documentation errors related to OMS surgeries/services.
7. Explain the role of clinical documentation improvement (CDI) in reducing medical necessity denials.
Continuing Education Provider Approval
The American Association of Oral and Maxillofacial Surgeons is an ADA CERP Recognized Provider.
ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education.
ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.
The American Association of Oral and Maxillofacial Surgeons designates this activity for 1.5 continuing education credits.
AGD - Accepted Program Provider
Provider ID# 214680
The American Association of Oral and Maxillofacial Surgeons (AAOMS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The American Association of Oral and Maxillofacial Surgeons designates this live activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.