On-Demand Learning

Resuming Medicare Claim Review

Program originally recorded October 19, 2021

This post has been archived and contains information that may be out of date.

Medicare claim reviews have been on hold since 2019 but will soon be resuming. CHA is happy to partner with Livanta to bring members crucial information about the resumption. During this webinar, participants will learn about Medicare’s Beneficiary and Family Centered Care-Quality Improvement Organization (BFCC-QIO) Program and will be introduced to Livanta’s claim review services program. Under contract with the Centers for Medicare & Medicaid Services (CMS), Livanta is the national BFCC-QIO contractor for Short Stay Reviews (formerly Two-Midnight Reviews) and Higher Weighted Diagnosis Related Group (HWDRG) Reviews. 

Topics to be discussed include:

  • Provider responsibilities under Medicare’s BFCC-QIO Program 
  • Short Stay Reviews (SSRs) and Higher Weighted Diagnosis Review Group (HWDRG)
  • Claim review sampling methodology
  • Improper Payment Reduction Strategy

Target Audience: Billing Managers, Utilization Managers, Coding Staff, Medical Officers, and Compliance Managers 

This content is restricted to members.