First Coast’s virtual symposium agenda

Kick off the 2025 Novitas and First Coast Medicare Compliance Matters Virtual Symposium by attending our introductory session. Meet the outreach and education management team and learn more about what to expect with this year's symposium events including:

• Be the first to hear about upcoming Novitas/First Coast and CMS initiatives
• Gain insight into the most frequent, pervasive and/or expensive improper payment errors
• Learn firsthand how to proactively avoid common billing and documentation errors

The Virtual Symposium only comes once a year, don't miss out on these important programs!

Medicare covers qualifying clinical trials and investigational, non-experimental devices under Investigational Device Exemptions (IDEs) when the requirements for reasonable and necessary use are met. During this webinar, we will review Medicare coverage and billing requirements. We will also address common billing and documentation errors and provide resources to avoid them.

Establishing electronic billing is the next step for providers/suppliers after successfully enrolling with Medicare. Not only is electronic billing more efficient, but it also supports secure transactions, enhanced compliance with billing requirements, and expedited reimbursement compared to paper claim forms. Join us for an overview of mandatory electronic claim submission requirements, electronic billing options, and beneficial compliance tips to support an easy transition to this billing format. 

When a provider/supplier disagrees with the initial determination made by the Medicare Administrative Contractor (MAC) regarding denial of enrollment, revocation of billing privileges, or an enrollment effective date, an opportunity is provided to pursue a provider enrollment appeals. This webinar will explore the types of provider enrollment appeals and rebuttals, the applicable enrollment decisions, the submission requirements, the determination responses, and any further appeal rights.

This session will provide an overview of epidural steroid injections as interventions for pain management. We will review coverage, limitations, utilization guidelines and documentation requirements. We will also review frequently asked questions, identify improper payment errors, and share best practices for compliant billing and documentation. 

Protecting the Medicare trust fund is the responsibility of everyone involved in the Medicare program, including providers and suppliers. Help prevent fraud, waste and abuse by establishing a proactive compliance program focused on improper payment prevention. Join us as we review the fundamental elements of a successful compliance program and identify critical resources for implementation guidance. 

Non-physician practitioners (NPPs) play a critical role in expanding access to care, improving patient outcomes, and supporting the efficiency of health care practices. This webinar will provide an overview of Medicare requirements for NPPs, including enrollment qualifications, billing options, and documentation standards. We will explore direct billing, incident to services, split (or shared) visits and how each billing option impacts Medicare reimbursement.

Services provided in an outpatient hospital setting to Medicare patients must comply various requirements for reimbursement consideration. This webinar will outline Medicare outpatient patient eligibility, coverage, billing requirements and reimbursement. We will provide an overview of the three-day payment rule and observation services and also highlight purposeful documentation requirements. We will conclude with a review of common improper payment errors identified by various review contractors and provide helpful resources to support Medicare compliance. 

This webinar will review the new prior authorization (PA) demonstration for certain ambulatory surgical center (ASC) services furnished on or after December 15, 2025, in Florida, Maryland, Pennsylvania, and Texas. The service categories targeted by the demonstration are:

Blepharoplasty, eyelid surgery, brow lift, and related services; Botulinum toxin injections, Panniculectomy, excision of excess skin and subcutaneous tissue (including lipectomy), and related services; Rhinoplasty and related services; and Vein ablation and related services. 

Under PA, the provider submits the prior authorization request (PAR) and supportive medical documentation to the MAC and receives an affirmed or non-affirmed decision prior to rendering the service. This webinar will review the PAR process, review decision timeframes, potential results and documentation guidelines. Members of our PA team will be available for questions relating to the PA demonstration.

This webinar promotes the concept of 'purposeful documentation' requirements for medical records and provide insights into acceptable signature criteria. We will identify common improper payment errors caused by insufficient documentation for a variety of service types and outline best practices to prevent these errors.

This webinar will explore global surgery billing guidance and define assistant-at-surgery reporting and documentation requirements. In addition, we will identify reporting modifiers for surgical procedures when performed by surgical assistants, co-surgeons or surgical teams and review tools available to validate modifier compliance. During this event, we will review when to use modifiers AS, 80, 81, 82, 62 or 66, explore the influence of these modifiers on Medicare reimbursement and present approaches to mitigate billing errors.

Medicare improper payment data demonstrates laboratory services are consistent contributors to the Part B error rate at the national and local contractor levels. This webinar will review enrollment qualifications, ordering and certifying requirements, coverage and billing guidelines, and purposeful documentation components. We will also outline common improper payment errors identified by various review contractors and provide helpful resources to support Medicare compliance.

During this webinar, we’ll review Medicare guidelines pertaining to facet joint interventions, addressing coverage criteria, eligible indications, restrictions, provider qualifications, billing practices, as well as essential purposeful documentation requirements. Additionally, we will emphasize the necessity of prior authorization for these services when administered in a hospital outpatient department setting.

This webinar will define the various types of Medicare coverage policies, demonstrate how to locate Medicare coverage policies, including national and local coverage determinations, and explore how to use them. We will also illustrate how to utilize various self-service tools to assist with locating Medicare policies. 

Accurate billing and documentation for office and outpatient evaluation and management (E/M) services is critical for compliance and reimbursement under Medicare guidelines. Join this webinar for an overview of the requirements for billing office and outpatient E/M services, including defining new versus established patients and level of service based on medical decision making or time-based billing. This webinar will review documentation standards to help avoid improper payment errors and support compliance with Medicare rules. 

Cataract removal surgery is a frequently performed procedure for Medicare beneficiaries. This webinar will define the coverage for cataract extraction when billing Medicare. Our focus will be on promoting compliance in billing and the necessary documentation requirements as outlined by the Internet-Only Manuals (IOM) guidelines. To help mitigate common billing and documentation mistakes, we will examine recent errors identified by the Comprehensive Error Rate Testing (CERT) program, Recovery Auditor (RA), and Novitas’ Medical Review (MR), while also identifying useful resources to avert these errors.

This webinar will define hospital provider-based departments, including off-campus provider locations requirements, and review billing guidelines for various reporting scenarios. To ensure ongoing compliance with enrollment address reporting changes, instructions will be provided regarding how to add a new practice location address or revise an existing location using the Provider Enrollment, Chain and Ownership System (PECOS) or the paper-based CMS-855A Medicare Enrollment Application for Institutional Providers.

This session will emphasize the importance of reporting the place of service (POS) code to indicate the setting where healthcare services were provided. We will define the most used POS codes, provide resources to assist in determining the correct code to use, and demonstrate options for how to correct claims when the incorrect POS is reported. 

This webinar will review the guidelines for reporting incident to and split/shared evaluation and management (E/M) services. We will review Medicare’s E/M guidelines, and cover billing and purposeful documentation requirements for services rendered incident to or split/shared among physicians and other qualified healthcare professionals. We will also review web-based resources to assist in complying with these requirements.

This webinar will review coverage, billing, and documentation guidelines for initial and subsequent annual wellness visits (AWV). We will also review the social determinants of health (SDOH) risk assessment as an optional part of the AWV. Using improper payment errors identified by the Comprehensive Error Rate Testing (CERT) and targeted probe and educate (TPE) program, we will highlight best practices and identify resources to prevent these errors. 

This webinar will offer a comprehensive exploration of inpatient and outpatient billing practices specific to critical access hospitals (CAHs) operating under Method I and Method II. We will examine key service areas such as laboratory and therapy services, and review the required reporting of provider reassignments for Method II practitioners to prevent future claim denials. We will review documentation standards that support accurate reimbursement, with particular focus on recent improper payment findings identified through the Comprehensive Error Rate Testing (CERT) program. 

This webinar will navigate hospital inpatient admission requirements defined by the Centers for Medicare & Medicaid (CMS), including an overview of the two-midnight rule as well as a short stay and offer clarification between them. Attendees will be provided with the definition and background along with the reimbursement ramifications of such admissions.  

This webinar will provide an overview of the various types of Medicare policies, including national coverage determinations (NCD), local coverage determination (LCD) policies and billing and coding articles and outline how they aid in complying with reasonable and necessary coverage, billing guidelines and documentation requirements. We will also review how to determine if an appeal or clerical reopening of a denied claim is necessary and identify steps to take to submit these requests.

During this webinar, we’ll explore compliance in care management and coordination service categories by reviewing coverage criteria, billing guidelines and purposeful documentation requirements. Service categories include chronic, principal, and transitional care. Using improper payment errors identified by the Comprehensive Error Rate Testing (CERT) program and concerns emphasized by the Recovery Auditor (RA), we’ll highlight best practices to prevent these billing and documentation errors.

This webinar is designed for Part B providers who provide outpatient rehabilitation therapy services. We will review Medicare coverage guidelines, billing and purposeful documentation requirements. We will also identify the most common improper payment errors and highlight resources to prevent them.  

This webinar will define the various fee schedules used by Medicare providers and demonstrate how to effectively navigate and use them to accurately bill and avoid unnecessary appeals. We will provide an overview of the Medicare Physician Fee Schedule Lookup Tool and clarify how to interpret the various fields within this valuable resource.

To prevent improper payments and protect the Medicare Trust Fund, Medicare Administrative Contractors (MAC) operate various types of medical review programs. Medical reviews involve the collection and clinical review of medical records and related information to ensure that payment is made only for services that meet all Medicare coverage, coding, billing, and reasonable and necessary requirements. During this webinar, we will review MAC specific medical review activities and identify resources to proactively support billing and documentation compliance guidance. 

This webinar will review Medicare requirements for radiology services and diagnostic procedures. We will examine the indicators related to both the professional and technical components, along with the necessary modifiers, place of service, and date of service billing requirements. The session will reinforce the importance of orders and purposeful documentation, while also addressing recent improper payment errors identified through the Comprehensive Error Rate Testing (CERT) program.

This webinar will provide an overview of the End Stage Renal Disease (ESRD) Medicare benefit. We will review the Part A and B provider's role in complying with Medicare coverage, billing and purposeful documentation requirements. We will discuss purposeful documentation requirements and avoiding improper billing errors commonly identified by the Comprehensive Error Rate Testing (CERT) program and Targeted Probe and Educate (TPE) reviews. 

This webinar will provide an overview of Medicare guidelines pertaining to genetic testing for cardiovascular disease and address covered indications, limitations and provider qualifications outlined in our local coverage determination (LCD). The session will clarify what Medicare considers reasonable and necessary, including clinical and genetic evidence required for coverage and review documentation and billing requirements.

The Medicare Integrity Program (MIP) was created to detect improper payments and ensure adherence to Medicare guidelines. This presentation will identify each type of review contractor and outline the responsibilities and functions assigned to each review contractor employed by the Centers for Medicare & Medicaid Services (CMS).  We will also review expectations and timelines associated with interactions and requests from each review contractor to avoid potential claim denials.

Telehealth is an effective health care delivery tool allowing for expanded access to reasonable and necessary services within the Medicare beneficiary community. In this webinar, we will identify Medicare-approved telehealth platforms, provider types and settings, eligible services, and define billing and documentation requirements. We will also review the most recent changes and flexibilities currently in effect and proposed for future implementation for Part A institutional facilities. 

Telehealth is an effective health care delivery tool allowing for expanded access to reasonable and necessary services within the Medicare beneficiary community. In this webinar, we will identify Medicare-approved telehealth platforms, provider types and settings, eligible services, and define billing and documentation requirements. We will also review the most recent changes and flexibilities currently in effect and proposed for future implementation for Part B providers. 

We will provide an overview of psychotherapy guidelines including documentation requirements, medical necessity, billing guidance and incident to requirements for individual, family and group therapy. We will review common errors identified from medical review audits and how to avoid those errors. 

This webinar will examine the differences between solicited and unsolicited overpayments, while exploring the options available to facilitate the recoupment process. We'll review how to submit voluntary refunds, request immediate offsets or extended repayment schedules, and identify self-service tools to access the repayment process. We will also outline the monetary penalties that may accrue if Medicare is not repaid in a timely manner. 

This webinar will provide a comprehensive overview of anesthesia coverage, billing practices, and essential documentation guidelines. We will examine different billing scenarios, anesthesia modifiers, requirements for medical direction of concurrent cases, calculation of time units, Monitored Anesthesia Care (MAC), as well as improper payments and documentation errors.

Discharge status codes identify where the patient is discharged or transferred to at the end of the facility stay and are an imperative component when billing acute hospital inpatient claims. Documenting an incorrect discharge status code not only impacts the hospital's reimbursement, but also affects any other facility from successfully submitting a claim to Medicare. This webinar will review the purpose of the discharge status code, billing guidelines, reimbursement impacts, and transfer policies. We will also review recent audit findings related to billing these services and highlight best practices to prevent future billing errors leading to costly overpayments. 

This webinar is designed for providers and suppliers who provide ground ambulance transportation. We will review coverage requirements, outline billing guidelines, examine the improper payment errors identified by the Comprehensive Error Rate Testing (CERT) program, and provide documentation guidelines for the trip record and the Physician’s Certification Statement (PCS).

Novitas Solutions and First Coast offer free online portals to assist with your Medicare compliance needs. This webinar will display features available in Novitasphere and SPOT and focus on how they apply to a provider's daily Medicare activities. We will demonstrate how to locate patient eligibility, view remittance advices, check appeal status, submit and retrieve documents, and much more.

This webinar will review Medicare’s guidelines for billing and documenting critical care services with a focus on avoiding improper payment errors. We will identify how to identify critical care encounters, apply time-based reporting requirements, and ensure compliance with supervision and medical necessity standards. At the conclusion of this webinar, we will review case examples identifying documentation gaps, incorrect time reporting, and misunderstanding of coverage rules with a focus on preventing improper payment errors.

Medicare claim review contractors continue to report an increase in improper payments associated with skilled nursing facility (SNF) claims with the main driver stemming from insufficient documentation. Join this webinar for an overview of SNF purposeful documentation requirements, identification of common documentation errors, and access to a variety of beneficial resources to avoid them.

This webinar will review coverage, billing, and purposeful documentation guidelines for chiropractic services. We will also identify Part B chiropractic improper payment errors and share resources aimed at proactively avoiding these errors. 

Medicare will consider reimbursement for drugs and biologicals after administration of the appropriate dosage for the patient’s condition. Errors related to drug dosage reporting and coverage requirements are top reasons contributing to incorrect claim billing. This webinar will provide coverage and billing guidelines for drugs and biologicals for Part A services. We will review topics such as purposeful documentation requirements, reporting the correct units, and the proper use of the JW and JZ modifiers

Medicare will consider reimbursement for drugs and biologicals that are reasonable and necessary to treat the patient’s condition. Mistakes associated with drug dosage reporting and coverage criteria are among the primary factors leading to erroneous claim submissions and subsequent claim denials. This webinar will provide coverage and billing guidelines for drugs and biologicals pertaining to Part B services. We will examine purposeful documentation requirements, accurate unit reporting, and the appropriate application of the JW and JZ modifiers.

In this webinar, we will explore remote therapeutic services and remote physiological monitoring. We will outline providers eligible to offer these services, essential insights into billing practices, criteria for what is considered reasonable and necessary, and purposeful documentation requirements.