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Webinar Details
- Pub Code: C3C12-11WEB
- Speakers
- Michael Taylor, M.D.
- Mark Miani, M.D.
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Medical Necessity and Cardiovascular Procedures: What Providers and Payers Need to Know to Protect Their Patients and Bottom Lines
March 14, 2013 Webinar - Listen On-Demand or Get a CD!
In the last year, the medical necessity of cardiovascular procedures has become perhaps the single most controversial — and financially significant — utilization review issue for hospitals and health plans alike. As the No. 1 target of Medicare recovery auditors and focus of high-profile investigations by the Department of Justice and the HHS Office of Inspector General, the medical necessity of cardiovascular procedures is a hot-button issue that affects the quality of care and the financial bottom line of hospitals and health plans. How successful is your organization in determining the appropriate setting (inpatient versus outpatient) for cardiovascular procedures, or whether a cardiovascular procedure itself is medically necessary? How do you deal with situations in which an ordering physician believes that a cardiovascular procedure is medically necessary, but your utilization criteria have not been satisfied? Get strategic guidance from experts on these and related questions that have a tremendous impact on the quality of patient care and the time, effort and resources you spend on Medicare compliance.
The On-Demand recording will be available immediately upon purchase* as a link within a PDF file of the accompanying written materials. CDs and printed materials are shipped via USPS.
Sponsored by Atlantic Information Services, Inc., publisher of Report on Medicare Compliance and A Guide to Complying With Stark Physician Self-Referral Rules
With billions of dollars of national health care charges at risk each year — and even more importantly, with the health of your patients and members at stake — it is critical for your organization to participate in the discussion of the medical necessity of cardiovascular procedures.
Hear Michael Taylor, M.D., and Mark Miani, M.D., of Medical Audit & Review Solutions (MARS) — hospital medical necessity experts who now conduct audits for payers — discuss the latest strategies for helping ensure the medical necessity of cardiovascular procedures. You’ll gain specialized, up-to-date utilization review knowledge concerning the medical necessity issues surrounding pacemakers, cardiac defibrillators, coronary artery stents, and peripheral angioplasty and stents.
You’ll get reliable answers to questions like:
- What is the best way for my organization to determine the medical necessity for cardiovascular procedures?
- What are the quality, safety, compliance and financial considerations related to performing cardiovascular procedures in the inpatient versus outpatient setting?
- Where can I find utilization review standards and coverage determinations for pacemakers, cardiac defibrillators, coronary artery stents, and peripheral angioplasty and stents?
- Why are the utilization standards related to cardiovascular procedures evolving, resulting in the increasingly frequent performance of cardiovascular procedures in the outpatient setting?
- What are the necessary elements for a sound, systematic utilization review approach to ensure determination of the medical necessity of cardiovascular procedures?
- How does the medical necessity of cardiovascular procedures relate to current government and private initiatives to detect health care payment error, waste, fraud and abuse?
Speakers
MICHAEL TAYLOR, M.D., is the president, CEO and founder of Medical Audit & Review Solutions (MARS), a physician-led company focused on medical necessity audit, analytics and review. Dr. Taylor has been widely recognized as a foremost industry expert in the fields of medical necessity assessment and utilization review. He is a frequent speaker at industry conferences and events and has been widely published in leading compliance and utilization review publications. He is board-certified in family medicine and is a graduate of Vanderbilt University School of Medicine and Harvard College.
MARK MIANI, M.D., is the vice president and chief medical officer at MARS, where he is responsible for oversight of all clinical operations. He is an industry expert with more than 20 years of domestic and international clinical and administrative medicine experience, including extensive experience in health care utilization working as a medical director in both the provider and payer spaces. Dr. Miani attended Albany Medical College and completed his training at George Washington University Medical Center. He is board-certified in internal medicine.
Moderator: Francie Fernald, Managing Editor of AIS's A Guide to Complying With Stark Physician Self-Referral Rules
Designed Especially For
Compliance officers, billing and coding managers, reimbursement directors, internal auditors, legal counsel, and financial and operations executives at
- Hospitals and health systems
- Health plans
- Integrated delivery systems
- Medical group practices
- Pharmaceutical companies
- Consulting firms
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Written Materials
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