CEU Related Queries - ceu@skillacquire.com | Upcoming Live Webinar - Wrangling Denials Into Dollars : Stop Unfair and Illegal Tactics by Insurance Carriers Register Here
$239
Format: | Live Webinar |
Presenter: | Kelly S. Grahovac |
Event Date: | Thursday, September 19, 2024 |
Time: | 1 pm ET | 12 pm CT | 11 am MT | 10 am PT |
Duration: | 60 minutes |
Location: | Online Webinar |
Event Materials (Key Required)
Course Description
The Affordable Care Act includes the 60-day overpayment rule, which requires suppliers to refund overpayments within 60 days of identification. What many suppliers aren’t aware of though is that if an overpayment is identified, either internally or externally, suppliers are mandated by law to perform a six-year lookback audit. This overly burdensome process has impacted hundreds of suppliers around the country and now that the TPE program has migrated to post payment reviews during the pandemic, this could impact even more suppliers. Even worse, if suppliers do not comply with this rule, they are at risk of false claim penalties. This panel will provide an overview of what is required of a supplier who is faced with an overpayment, how to manage the situation, what risks are associated with the overpayment rule and most importantly, how to mitigate your risk when dealing with this process. Lastly, the panel will provide real life case studies of suppliers who have experienced this challenge and the outcomes.
Learning Objectives
Areas Covered in the Session
Suggested Attendees
About the Presenter
Kelly Grahovac serves as the General Manager for The van Halem Group where she focuses on audits, appeals, education and training, and business development, in addition to management duties. Kelly is a known lecturer in the DME industry, speaking at national conferences, state associations, and for private events. Kelly came to The van Halem Group with 10 years of experience at one of the nation’s leading Medicare contractors where she worked for the Durable Medical Equipment Regional Carrier (DMERC), Qualified Independent Contractor (QIC), and A/B Medicare Administrative Contractor (MAC). Her various roles with Medicare include working as a senior provider relations representative, QIC Adjudicator and Training Specialist. Kelly has in-depth knowledge in Medicare appeals, policy, education, and training. Kelly is an active member of the Health Care Compliance Association (HCCA) and currently serves on the Medicare DME MAC Jurisdiction D Advisory Council, as well as the National Supplier Clearinghouse (NSC) Advisory Council. Kelly is also an active board member for the South Carolina Medical Equipment Suppliers Association (SCMESA). In addition to her client work at The van Halem Group, Kelly is also a contributor to several industry publications nationally.
Additional Information
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Email: care@skillacquire.com
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"This program on HIPAA did a great job providing actionable concepts in a way that updated our team and me, I now know how I will implement the concepts because I already did it in their online seminar, it was easy to ask questions from the speaker at the end of my 60 minutes course."
Melissa Preston, Health Information Management Staff
"David Vaughn covered the material completely and I have a new understanding of when, where and why we need to use an ABN"
Sandie Fowler, Out of Network Billing Staff
"Great presentation. Able to do during the day. Timing was great."
Tina Duffy, Compliance Officer