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Medical Necessity - Primer on Key Legal Principles and Operational Compliance

  • Training

  • 90 Minutes
  • Compliance Online
  • ID: 5975143
This webinar on the legal principles of 'Medical Necessity' will cover the compliance background and provide practical advice on how healthcare providers can understand and apply ‘medical necessity’ principles.

Why Should You Attend:

'Medical Necessity' principles are a fundamental component of health care delivery and payment for both government and private health plans. Moreover, both individual and organizational providers face undesirable consequences if they do not learn and follow these principles. The consequences range from mere ‘warning notices’ to possible criminal charges.

The objective of this 90-minute webinar is to provide a solid frame of reference for those who must deal with ‘medical necessity’ issues as part of their core job responsibilities.

The session designed to provide historical and legal context that will help attendees understand the social and payment policies related to medical necessity determinations, as applied in our health care industry. The webinar also will analyze specific statutory and regulatory authorities that are the sources of most interpretive differences of what is or is not a ‘medically necessary’ item or service. Several, specific examples of clinical services will be discussed.

Areas Covered in the Webinar:

  • Legal Overview
  • Examples of how payment reforms relate to ‘medical necessity’
  • Enforcement techniques and related sanctions
  • Suggestions for reducing risks of denials, repayment obligations and other legal penalties
  • Methods to educate and train providers and support personnel on ‘medical necessity’

Who Will Benefit:

The following personnel in medical offices, hospitals, medical centers and clinics will benefit:
  • Clinical Service Administrators
  • Process Improvement Teams, especially Revenue Cycle and Patient Accounts
  • Clinicians
  • Compliance Professionals
  • Financial Officers
  • Physicians
  • It will also benefit business associates providing accounting and billing services.

Course Provider

  • John Steiner
  • John Steiner,