Telehealth in 2025: Key Changes, Insurance Denials and Effective Appeal Strategies under CMS's New Physician Fee Schedule

Session 1 - The Future of Telehealth: 2025 Changes

Pre-recorded Webinar (Instant Access)

Duration - 60 Mins

Speaker - Lynn M. Anderanin

Webinar Description

Telehealth completely changed in 2020 when the Public Health Emergency was put into effect.  Now in 2024, many of those temporary changes are expiring and the telehealth business has exploded.  These methods of communication between provider and patient are loved by many, and the convenience of telehealth in healthcare has become a common occurrence. 

This webinar will be reviewing the current parts of telehealth that are being considered permanent in the 2025 Physicians Fee Schedule Final Rule and the new evaluation and management services that are new codes for CPT in 2025 related to telehealth.  We will find out what the do’s and don’ts of telehealth that are here to stay, as well as implementing these new codes and regulations into your practice.

Webinar Objectives

These new rules and codes are important to any one currently offering telehealth as well all who are considering it to add it to their practice in order to be compliant and maximize reimbursement for the services performed. 

Webinar Agenda

• Telehealth Today
• Final Rule Changes 2025
• CPT  codes
• Implementing it in Practice

Webinar Highlights

1. The CMS Telehealth List and how to use it
2. Medicare’s rules for 2025
3. G codes for Medicare telehealth
4. CPT addition of 17 codes to the E/M section for Telehealth
5. Education for office staff
6. Implementation on your software programs

Session 2 - Insurance Denials - Understand How To Appeal, Track & Never Lose Money From Payers

Pre-recorded Webinar (Instant Access)

Duration - 60 Mins

Speaker - Lynn M. Anderanin

Webinar Description

A part of the revenue cycle that has gathered a lot of attention in the last few years are claim denials.  Denials can become a very complex and frustrating because they aren’t always appropriate, which makes many questions how the insurance carriers can deny claims erroneously.  It is important that part of each practice’s revenue cycle include addressing denials with tracking, reviewing, and appealing denials when they are inappropriate. 

This webinar will discuss tips on implementing and handling denials to ensure that the practice is not losing money which should be collected from the insurance companies.

Webinar Objectives

Many offices have difficulty finding the time to work denials because of other tasks that seem to be of more priority and yet many denials are received in error and will be money lost if they are not solved in the timely filing period.  When denials are worked by a process, and the burden is shared between many in the office, denials are not so much a burden but an important part of the revenue cycle process.

Webinar Agenda

• Understanding denial and remark codes
• Determining staff involvement
• Investigate what help can come from automation in the PM system
• Template letters for like denials
• Creating metrics to be able to see a new denial

Webinar Highlights

1. Reading explanation of benefits
2. Utilize insurance carriers forms and processes for reconsideration and appeal
3. Track denials to be aware of unannounced policy changes and make corrections to avoid future denials
4. Determine the capability of the PM system to assist or the creation of a manual process
5. Assign different parts of denial management to qualified staff
6. Have a successful process so that all claims that should be paid, are paid.

Session 3 - CMS 2025 Proposed Physicians Fee Schedule

Pre-recorded Webinar (Instant Access)

Duration - 60 Mins

Speaker - Lynn M. Anderanin

Webinar Description

Each and every year CMS goes through the process of creating the Physicians Proposed Fee Schedule to become effective on January 1st of the following year.  The proposed rule is available in July, and there is a 60-day comment period in which anyone can comment on the proposed rule.  At the end of the 60 days, CMS reviews all the comments and in the first week of November the final rule appears in the Federal Register.  There can be differences between the proposed rule and final rule, but most frequently there are revisions, but not major changes.

Webinar Objectives

The annual Physicians Fee Schedule Proposed Rule can have a major impact on the reimbursement for particular procedures or services, or all of the items on the CMS fee schedule.  Understanding the possible rules before they are final helps office prepare for the upcoming year in determining the procedures and services they will offer, and the financial impact of the changes to their bottom line. 

Webinar Agenda

• Implementing the changes from a workflow perspective
• Applying it to the practice to understand the financial impact to the practice
• Education of the pertinent staff within the practice in time for the changes

Webinar Highlights

1. Highlights of the Proposed Fee Schedule
2. How do the proposed rule differ from the present rules
3. How to analyze the rule to implement the pertinent changes to your practice
4. Preparing to make revisions when the Final Rule is published
5. How to submit comments to CMS about the proposed rule

Who Should Attend

Physicians, Advanced Nurses, Physician’s Assistant, billers, coders, compliance, managers, administrators, case managers, claims processors, collection staff, managers, supervisors, directors, CEO, CFO, surgery schedulers, auditors, claims adjusters