Navigating Medicare Advantage Compliance: Best Practices One Year After the Two-Midnight Rule

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06 Mar

Navigating Medicare Advantage Compliance: Best Practices One Year After the Two-Midnight Rule

Navigating Medicare Advantage Compliance: Best Practices One Year After the Two-Midnight Rule

Thursday, March 6, 2025 (12:00 AM to 11:59 PM)
1.0 PDCs
Provider: MGMA
Course Name: Navigating Medicare Advantage Compliance: Best Practices One Year After the Two-Midnight Rule

Speaker: Kyle McElroy
Program Type: Videoconferences, webcasts, audiocasts, podcasts, eBooks, self-directed E-Learning
Registration URL: https://www.mgma.com/webinars/navigating-medicare-advantage-compliance

Email Details

This 60-minute webinar will provide you with the knowledge to: • Produce effective strategies that strengthen partnerships with managed care organizations and payers, emphasizing the role of Joint Operating Committee (JOC) meetings • Employ best practices for enhancing Case Management and Utilization Review to ensure compliance with Medicare Advantage requirements and reduce denials • Use data-driven approaches to identify trends, prevent claim denials, and streamline revenue cycle management

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The 2024 Medicare Advantage final rule introduced significant changes to inpatient coverage, particularly the application of the “two-midnight rule.” Unlike traditional Medicare Part A, Medicare Advantage plans are not required to grant automatic inpatient status approval based on this rule, enabling ongoing audits under provider contracts. One year after implementation, navigating these complexities is more critical than ever for physician practices to maintain compliance and ensure proper reimbursement. In this discussion, Kyle McElroy from Conifer Health Solutions will share actionable strategies to build effective partnerships with payers through Joint Operating Committee (JOC) meetings, improve Case Management and Utilization Review workflows, and strengthen compliance to minimize denials. This session will also highlight the value of Physician Advisor Programs in bridging clinical care and administrative requirements. Attendees will gain insights into leveraging data-driven techniques to prevent claim denials and craft successful appeal letters, empowering practices to thrive in the evolving Medicare Advantage landscape.