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On Demand

Will HEDIS Prevent Payment & Increase Barriers for Low Back X-rays?


Credit Available - See Credits tab below.

Average Rating:
   18
Topic Areas:
Mandated CE
Categories:
Billing & Coding |  On Demand
Speaker:
Evan Gwilliam, DC, MBA, BS, CPC, CCPC, QMCC, CPMA, CPCO, AAPC
Duration:
1 hour
Format:
Audio and Video



Description

What if there were a simple, no-cost step that could keep both your members' practices and the chiropractic profession off of the radar? Federal health plans set the standard for reimbursement for all insurance carriers. They are evaluated based on their performance in a program called HEDIS (Healthcare Effectiveness Data and Information Set), which seeks to improve healthcare outcomes and reduce costs.  One of the measures they are evaluated on is the use of imaging studies for low back pain.  If they get a bad rating, they will likely impose more conditions (i.e., pre-authorization, denied claims, increased documentation requests) on providers who take low-back films, making it harder for DCs to get paid.  But you can find out the criteria that are used in order to make sure that your X-rays are medically appropriate and therefore reimbursable.  Join us in this action-packed presentation to find the answers you need to get paid and get along with payers all at the same time.  

Sponsored by: Infinedi

Credits


Mandated Distance Learning

Approved for 1 mandated (Billing & Coding) Distance Learning CE hour(s) by the CA Board of Chiropractic Examiners: CA-D-24-01-12140.



Handouts

Speaker

Evan Gwilliam, DC, MBA, BS, CPC, CCPC, QMCC, CPMA, CPCO, AAPC's Profile

Evan Gwilliam, DC, MBA, BS, CPC, CCPC, QMCC, CPMA, CPCO, AAPC Related Seminars and Products


After eight years running his own clinic, and then earning seven different insurance coding and compliance and audit certifications, Dr. Gwilliam has become a seminar speaker, consultant and teacher around the country.  As a physician, he is well versed in medical terminology, anatomy, and documentation for medical necessity.  As an instructor, he prepared students for the CPC exam and created a curriculum which improved pass rates by 50%.  And, as a consultant, he has conducted audits, analyzed business practices, and solved insurance-related issues. He holds a Bachelor’s Degree in accounting. Dr. Gwilliam speaks around the country on coding, Medicare, and compliance.  He is also a certified ICD-10 instructor through the American Academy of Professional Coders.


Reviews

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Overall:      4.9

Total Reviews: 18