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Clinical Validation Denials: No Longer Uncommon, Definitely Unwelcomed amid Rampant Auditing

Monday, September 20, 2021 
10-10:30 a.m. EST; 7-7:30 a.m. PST
Season 11, Episode 469

SPECIAL GUEST
Erica Remer, MD, CCDS
Founder and President, Erica Remer, MD, Inc.

FEATURING
Knicole Emanuel, Esq.;
Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP;
David Glaser, Esq.; and Ronald Hirsch, MD, FACP, CHCQ

Reports of rampant Medicare and Medicaid auditing are pervasive. It seems like every day, hospitals and physician practices are undergoing audits of their medical claims.. These are clinical validation audits, the type of auditing in which the rejections of claims are based on someone’s subjective opinion that certain medical conditions were not present.

Reporting on these all-too-common and unwelcomed clinical validation denials will be Erica Remer, MD, a special guest during the next live edition of Monitor Mondays.  Dr. Remer, a member of the ICD10monitor editorial board, is also the popular co-host of Talk Ten Tuesdays, the long-running Internet radio broadcast produced by ICD10monitor.

Monitor Mondays will also have the latest national audit news updates from well-respected broadcast consultants, including:

  • Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will return with another installment of his popular segment.
  • RAC Report: Healthcare attorney Knicole Emanuel, a partner at the law firm of Practus, will file the Monitor Mondays RAC Report.
  • Legislative Update: Former Centers for Medicare & Medicaid Services (CMS) official Matthew Albright, now chief legislative affairs officer for Zelis, will report on the latest healthcare regulatory news coming out of Washington, D.C.
  • Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment, reporting on legal implications facing healthcare providers.
  • SDoH Report: Ellen Fink-Samnick,anationally recognized expert on the social determinants of health (SDoH), will have the latest news on a trending topic that is attracting significant media attention. Ellen will also conduct the Monitor Mondays Listeners Survey.