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Escalation Policies: What Are They and What Is Their Purpose?

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Part Number:0521COMP

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NAMAS Compliance Webinar Series
May 11, 2021 | 2:00 pm EDT

Escalation Policies: What Are They and What Is Their Purpose?
Speaker: Sean Weiss, CHC, CEMA, CMCO, CPMA, CPC-P, CMPE, CPC

Policies are more than just words on a paper and in order to demonstrate a “Culture of Compliance” they have to be effective and actionable and that includes “Escalation Policies”, which are used within an organization to highlight any issues that need correcting. In relation to coding, an initial audit is performed to gauge the accuracy of providers. Those providers falling below the organization’s accuracy threshold, face consequences ranging from education and re-audit to pre-bill review of all of their claims. The idea is not punishment but to rectify coding/billing issues and protect the organization from False Claim Act allegations.

5 Stars
Revenue Integrity Auditor
Great information and the speaker was very clear.
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Reviewed by:  from Knoxville. on 5/11/2021
5
5 Stars
Physician Education Manager
Awesome Presentation. Sean is a great speaker.
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Reviewed by:  from Indiana. on 5/11/2021
5
5 Stars
Coder 2
I thought this was great. He gave pertinent information, and rather than re-reading the slides, he added side notes that were very helpful. I need to keep up with my education for auditing and compliance, because I'm not working in that capacity at the moment. Thank you.
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Reviewed by:  from The Oregon Clinic, PC. on 5/11/2021
5
4 Stars
Manager
Sean gave a great presentation today. I really appreciate him including real life experiences.
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Reviewed by:  from Michigan . on 5/11/2021
4
5 Stars
Senior Consultant & Manager
Sean is always the most engaging and insightful speaker! The way he goes about presentations provides you with factual and practice learning from experience and examples in addition to covering key concepts of the topic! I always go out of my way to join his session!
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Reviewed by:  from Chicago, IL. on 5/11/2021
5

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