Halt Medicare Secondary Payer Denials & Get Paid More

Event Materials (Key Required)

Course Description

Navigating Medicare Secondary Payer (MSP) rules is essential for healthcare professionals who want to ensure compliance, reduce denials, and maintain proper reimbursement. This comprehensive webinar will provide attendees with a solid foundation in MSP guidelines, focusing on when Medicare is considered the secondary versus the primary payer.

We will explore key scenarios involving group health plans, workers’ compensation, auto and liability claims, and other coverage types that affect Medicare’s payment responsibilities. Participants will gain clarity on how to determine payer order, correctly report MSP cases, and avoid common billing pitfalls that can result in audits or overpayments.

Through real-world case examples and up-to-date CMS guidance, attendees will walk away with practical tools and strategies to improve accuracy in claims processing and patient registration workflows. Special attention will be given to proper documentation, conditional payments, and the importance of the Coordination of Benefits (COB) process.

This session is ideal for medical coders, billers, compliance officers, revenue cycle managers, and providers seeking to understand and apply MSP rules effectively. Join us to strengthen your knowledge and stay compliant in the ever-evolving healthcare landscape.

Learning Objectives

• Define the Medicare Secondary Payer (MSP) program and explain its purpose within the healthcare reimbursement system
• Identify the most common scenarios in which Medicare is the secondary payer, including group health plans, workers’ compensation, and liability claims
• Understand the coordination of benefits (COB) process and how to determine the correct primary payer before submitting claims to Medicare
• Apply CMS rules and guidelines for reporting MSP situations accurately to ensure compliance and avoid claim denials or penalties
• Recognize red flags and documentation requirements for MSP cases to support appropriate billing and reimbursement
• Implement best practices and workflows for proactively managing MSP cases in your organization or practice
• Analyze real-world case examples to enhance practical understanding of MSP application and improve decision-making in complex billing scenarios

Areas Covered in the Session

• Avoid Costly Billing Errors: Learn how to properly identify when Medicare is the secondary payer to prevent denials, audits, or recoupments
• Stay Compliant with CMS Rules: Understand the most current Medicare Secondary Payer regulations and reporting requirements
• Clarify Complex Scenarios: Gain clarity on real-world examples involving group health plans, liability, no-fault insurance, workers’ compensation, and COBRA
• Improve Claims Accuracy: Master how to bill clean claims the first time and reduce rework due to MSP missteps
• Protect Reimbursement: Ensure you are collecting from the correct primary payer and not leaving revenue on the table
• Live Q&A Session

Explore More Trending Courses:

• AI in Action: Real-World Applications for Credentialing and Primary Source Verifications
• Credentialing 101: A Detailed Guide to Provider Credentialing

Suggested Attendees

• Healthcare Providers
• Coders
• Billers
• Hospitals and Facilities
• Physician-Based Practices
• Auditors
• Administrators
• Office Managers
• Practice Managers
• Administrative Staff
• Legal
• Healthcare Consultants
• Compliance Officers
• Insurance Companies

About the Presenter

Keisha Wilson, CCS, CPC, CPCO, CPMA, CRC, CPB, AAPC Approved Instructor, the founder/ CEO of KW Advanced Consulting, is a seasoned professional with over 20+ years of experience in the healthcare field. Her career in large teaching hospitals and acute ambulatory care systems includes roles such as an outpatient coding specialist, clinical documentation improvement (CDI) specialist, compliance operations coding and billing manager, interim compliance director, and consultant to various coding companies. Her extensive experience is a testament to her leadership and deep understanding of the industry.

Keisha is not just a subject matter expert in Compliance and Revenue Cycle Management but also a dedicated educator and trainer. She excels in Risk-Based Audits, Retrospective, Prospective, Evaluation and Management audits, and auditing and coding of multi specialty, documentation, and coding Telehealth/ Telemedicine services, Risk Adjustment/ HCC provider and coder education/ training and webinars. Keisha has developed and implemented numerous compliance documentation and coding training programs for organizations of all sizes. She is an approved instructor for KW Advanced Consulting and an adjunct instructor for the American Academy for Professional Coders (AAPC), teaching a wide range of compliance and coding courses.

Keisha's dedication to sharing her expertise extends beyond her professional roles. She serves on the Board of Directors for an outpatient mental health clinic and actively participates in various telehealth and compliance committees. As a published author, she regularly contributes coding articles for KW Advanced Consulting, keeping the industry updated with the latest developments. Her collaboration with the AAPC editors on various Primary Care Coding Alerts and AAPC Magazine (formerly Healthcare Business Monthly) is a testament to her commitment to advancing the field.

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

Live Course Cancellation Policy: If for any reason Skillacquire need to cancel this program, Skillacquire will notify participants by email of the cancellation no less than 24 hours prior to the expected start time.

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. 

Snippet From Our Previous Session

Testimonials