National Health Care Anti-Fraud Association (NHCAA) 2024 Annual Training Conference
About the Event
Join MedReview in New Orleans Nov. 19-22 at the NHCAA Annual Training Conference
Visit us at booth #203
MedReview is heading to the birthplace of jazz to discuss the payment integrity challenges payors face, including shifting complex claims reviews to pre-pay, enhancing the provider experience, addressing the high costs of inefficient processes, and overcoming post-pay recovery obstacles.
The good news is that, with our physician-led pre-pay and post-pay solutions, we will work with you to overcome those challenges with our custom-tailored solutions. Join us at booth #203 to learn more!
On Thursday, November 21, don’t miss Dr. Michael Menen’s exploration of how AI can benefit or detract from successful payment integrity programs.
Presentation: AI Denial Prediction Software: More Accurate Claims or Fraud?
Date/Time: Thursday, November 21, 2024 2:45 – 3:45 p.m. CST
Presenter: Michael Menen, MD, Chief Medical Officer, MedReview Inc.
Synopsis:
Insurance companies deploy AI-powered decision support systems to analyze claim data aimed at enhancing consistency and ensuring adherence to guidelines and standards. Denial prediction software uses AI to analyze historical data on denials and appeals and identify patterns indicative of a higher likelihood of denial. This can enable healthcare staffers to fix the flagged items before submission, ultimately reducing the risk of denials. Used appropriately, this will improve accuracy and save time and money. Used inappropriately, it could make it harder to separate fact from fiction. Join this session to learn about the risks, including the creation of contradictory or duplicative notes, and explore the ethical questions surrounding AI-generated documentation. The speaker will also consider the broader implications for patient care and the trajectory of clinical documentation.