On this episode of The Pulse, host Lori Cox teams up with guest Dawn Carter to discuss the crucial role of social determinants of health (SDOH) in shaping health outcomes. Did you know that SDOH account for a staggering 80 to 90% of health outcomes? Lori and Dawn examine the five major domains of SDOH. They also highlight the importance of appropriate screening tools, such as P.R.E.P.A.R.E., for improving documentation and effective data collection. With nearly 60% of individuals reporting that they have never discussed SDOH with their healthcare providers, Lori and Dawn emphasize the need to raise awareness and facilitate conversations around SDOH to ultimately drive better healthcare outcomes.

From Awareness to Action: Tackling Social Determinants of Health

As audits are increasing across the country, you need to know how to defend your reimbursements from payers and CMS. In this podcast of The Pulse, Lori Cox sits down with Michael Miscoe, an accomplished attorney, coding and software development professional, and former President of AAPC’s National Advisory Board. 

 

They discuss post-payment audits and clawbacks, dive into statistical samples, and share insights on defending coding accuracy, when to seek legal advice, and how to leverage third-party support if audited or fined.  

 

Listen now to: 
 

Explore the best approach for compliance plans, especially for smaller physician practices. 

Uncover the complexities of auditing medical claims, including identifying and correcting errors in E/M services. 

Discover distinctions between federal healthcare program claims and non-federal claims, unraveling the obligations triggered by potential incorrect payments.

Tackling Post-Payment Audits

The Pulse by AAPC examines the business of healthcare to help simplify the challenges faced by revenue cycle management experts.

Tackling Post-Payment Audits

The Pulse by AAPC

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