Master 2024 CMS Interoperability and Prior-Authorization Rules for Faster Payor’s Approval

Event Materials (Key Required)

Course Description

Centers for Medicare & Medicaid Services (CMS) issued the final rule for CMS Interoperability and Prior Authorization, which aims to improve prior authorization processes and enhance patient, provider and payer access to interoperable patient data.

Prior Authorizations serve as a cost containment strategy that third-party payers leverage to control costs, restrict patient access to services, testing, and medications, and ultimately discourage medical providers from ordering unnecessary medical treatment. Prior authorizations are a major source of headaches for healthcare providers across the country. Despite the intention to control costs and ensure appropriate care, the prior authorization process has been criticized for its enormous administrative burden, potential delays in necessary medical treatment, and added complexity for healthcare providers.

Striking a balance between cost control and efficient patient care remains a major challenge in the healthcare industry. Join us for an insightful webinar where expert Don Self will take a deep dive into the complexities of the Prior Authorization process, discuss the pearls and pitfalls, define medical necessity requirements, and demystify the intricacies of obtaining prior authorizations, ensuring a smoother workflow and higher approval outcomes in 2024. Don will also discuss the CMS Interoperability and Prior Authorization Rule and how significantly impacts payers approval and denial practices. 

Learning Objectives

• Understand the major Prior Authorization Updates for 2024
• Understand CMS Interoperability and Prior Authorization Final Rule
• Recall medical necessity and the critical role it plays in the Prior Authorization approval process
• Identify which insurance payers require Prior Authorizations
• Recall methods for obtaining Prior Authorizations in 2024
• Recognize common challenges experienced when obtaining Prior Authorizations
• Understand how to escalate and appeal Prior Authorization denials 

Areas Covered in the Session

• CMS Prior Authorization Updates for 2024
• CMS Interoperability Rule
• 2024 Prior Authorization requirements for Medicare Advantage Plans
• Define medical necessity and the critical role it plays in the Prior Authorization approval process
• Regulatory landscape for Prior Authorizations in 2024
• Identify which insurance payers require Prior Authorizations in 2024
• Methods for obtaining Prior Authorizations
• Common challenges experienced when obtaining Prior Authorizations
• Outline successful strategies to overcome challenges with obtaining Prior Authorizations
• How to escalate and appeal Prior Authorization denials in 2024
• Best practice compliance tips for Prior Authorizations
• Live Q&A session

Suggested Attendees

• Medical Providers
• Administrators
• Office Managers
• Medical Billers
• Claims Coders
• Billing Staff and Companies
• Physicians and Other Providers
• Healthcare Consultants
• Compliance Officers
• Practice Manager
• In and Out of Network Providers
• Medical Billing Companies
• Providers Office Staff
• Hospitals and Facilities
• Insurance Companies
• Healthcare Attorneys

About the Presenter

Don Self, CPC, CMCS, CASA, is the CEO and founder of Don Self & Associates, a consulting firm specializing in medical reimbursements and helping physician practices improve patient outcomes and increase profits while staying compliant with all regulations. Don is also the President of Telecare-USA. Don has taught more than 900 seminars/ webinars over the past 38 years to tens of thousands of physicians, NPPs, coders and billers on coding, revenue, reimbursement and billing and 49 webinars in 2020 on Telehealth Billing. He has helped thousands make sure they are paid properly by Medicare and other payers.

Additional Information

After Registration: You will receive an email with login information and handouts (presentation slides) that you can print and share with all participants at your location.

System Requirement:

• Internet Speed: Preferably above 1 MBPS
• Headset: Any decent headset and microphone which can be used to talk and hear clearly

Can’t Listen Live? No problem. You can get access to an On-Demand webinar. Use it as a training tool at your convenience.

For more information, you can reach out to the below contact:

Toll-Free No: 1-302-444-0162

Email: care@skillacquire.com 

This is a Live Virtual session.

A new way of immersive learning that allows you to engage live with our instructor and peers providing you with the flexibility to juggle the new work-life balance.

Purchase Order Form - Click Here to download PO form. 

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