On-demand learning: Medical review & prior authorizations

December 19, 2025

Title	Line of business	Description	Format	Duration	Links
New Prior Authorization (PA) Demonstration for Certain Ambulatory Surgical Center (ASC) Services	Part B	This webinar will review the new prior authorization (PA) demonstration for certain ambulatory surgical center (ASC) services for the states of 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.	Webinar	Self-paced	View recording Take survey
Part B Insider's Guide to Mitigating Comprehensive Error Rate Testing (CERT) Errors	Part B	The Comprehensive Error Rate Testing (CERT) program identifies improper payment rates to determine the national and Medicare Administrative Contractor (MAC) improper payment error rates. In this webinar, we will explain the CERT review process and review the significance of responding to documentation requests. We will also review the most frequent Part B improper payment errors including ambulance services, chiropractic services and drugs and biologicals. We will share resources aimed at proactively avoiding these errors.	Webinar	Self-paced	View recording Take survey
Part A Insider's Guide to Mitigating Comprehensive Error Rate Testing (CERT) Errors	Part A	The Comprehensive Error Rate Testing (CERT) program identifies improper payment rates to determine the national and Medicare Administrative Contractor (MAC) improper payment error rates. In this webinar, we will explain the CERT review process and review the significance of responding to documentation requests. We will also review Part A skilled nursing facility (SNF) improper payment errors and share resources aimed at mitigating these errors.	Webinar	Self-paced	View recording Take survey
Local Coverage Determination (LCD) Additions and Revisions	Part A and Part B	This webinar will include new and revised local coverage determinations and local coverage articles. The session will review non-invasive arterial duplex ultrasound of the upper and lower extremities, gastrointestinal pathogen panels utilizing multiplex nucleic acid amplification techniques, molecular pathology and genetic testing and more. We’ll also provide guidance regarding application of the FastTrack to Medicare coverage policies self-service tool.	Webinar	Self-paced	View recording Take survey
Quarter 2 2025 - Insider's Guide to Mitigating Comprehensive Error Rate Testing (CERT) Part A Errors	Part A	The Comprehensive Error Rate Testing (CERT) program identifies improper payment rates to determine the national and Medicare Administrative Contractor (MAC) improper payment error rates. In this webinar, we will explain the CERT review process and review the significance of responding to documentation requests. We will also review Part A inpatient rehabilitation facility (IRF) improper payment errors and share resources aimed at mitigating these errors.	Webinar	Self-Paced	View recording Take survey
Medicare Navigator Coverage and Policy: Understanding Local Coverage Determinations	Part A and Part B	The Medicare Navigator Coverage and Policy series is designed to support providers with searching, locating and understanding Medicare coverage requirements. This webinar will provide an overview of local coverage determinations (LCD) and billing and coding articles and how they aid in determining reasonable and necessary criteria and billing requirements for a variety of services.	Webinar	Self-paced	View recording Take survey
Insider's Guide to Mitigating Comprehensive Error Rate Testing (CERT) Errors	Part A	The Comprehensive Error Rate Testing (CERT) program identifies improper payment rates to determine the national and Medicare Administrative Contractor (MAC) improper payment error rates. In this webinar, we will explain the CERT review process and review the significance of responding to documentation requests. We will also review the most frequent Part A improper payment errors, including inpatient hospital services and claims categorized under diagnosis-related group (DRG) coding. We will conclude with resources aimed at mitigating CERT errors.	Webinar	Self-paced	View recording Take survey
Insider's Guide to Mitigating Comprehensive Error Rate Testing (CERT) Errors	Part B	The Comprehensive Error Rate Testing (CERT) program identifies improper payment rates to determine the national and Medicare Administrative Contractor (MAC) improper payment error rates. In this webinar, we will explain the CERT review process and review the significance of responding to documentation requests. We will also review the most frequent Part A improper payment errors, including inpatient hospital services and claims categorized under diagnosis-related group (DRG) coding. We will conclude with resources aimed at mitigating CERT errors.	Webinar	Self-paced	View recording Take survey
Local Coverage Determination (LCD) Additions and Revisions	Part A and Part B	This course will include new, revised and proposed local coverage determinations and billing and coding articles. We will review cervical fusion, biomarkers for oncology, cardiac rhythm device evaluation, immune globulin, pharmacogenomics testing and more.	Webinar	Self-paced	View recording Take survey
MAC Medical Review Best Practices – Updating your contacts information	Part B	Recently, it has come to Medicare Administrator Contractor’s (MAC) attention that providers are receiving “non-documentation” denials during the medical review process. We are excited to share some tips on how you can best prepare to respond to additional documentation requests (ADRs) for a review of your records and prevent unnecessary denials.	Video	0:9:34	View video Take survey
Medicare Exemption: Prior Authorization of certain hospital outpatient department (HOPD) services	Part A	This video is a question-and-answer session facilitated by the Medicare Administrative Contract (MAC) Prior Authorization Collaboration Workgroup to ensure consistency in educational efforts regarding the prior authorization for certain hospital outpatient services (HOPD) exemption process.	Video	0:07:40	View video Take survey