Medical Necessity and Compliance Essentials for Everyday Practice

When:  Jun 20, 2019 from 9:00 AM to 4:00 PM (ET)

Now more than ever, health plans are starting to scrutinize Evaluation Management (E/M) coding for medical necessity and health care providers are faced with an array of complex requirements.  MSMS will provide tools, practical suggestions and guidance to help you implement policies and procedures.


Medical Necessity – Tips on Documentation to Prove it

This session is designed to help recognize that words and the specificity of diagnosis selection is key to proving medical necessity.  It will cover:

  • Medical necessity is the “overarching criterion” for services – What does that mean?
  • How can a few words make the difference?
  • ICD-10 code selection can make it easier
  • Having trouble with prior authorizations – Are they being denied for medical necessity?

Essentials for Avoiding and Preparing for Regulatory Investigations

  • Discuss preventive strategies to avoid an audit
  • Recognize “red flags” that trigger audits
  • Identify key steps to prepare for an audit
  • Explain the importance of the attorney-client privilege


  • Identify OSHA/MIOSHA standards applicable to health care
  • Assess facility-specific needs based on a checklist of resources
  • Describe a proactive approach to compliance with health care safety standards

Medical Records: What You Need to Know and Other Compliance Questions

Explain state and federal regulations governing medical records including:

  • Confidentiality
  • Who has access and when must access be provided
  • Retention
  • Destruction
  • Copying fees
  • Electronic medical record nuances


Who should attend: Physicians, PO Administrators, Practice Consultants, Office Administration and all other health care professionals.


Statement of Accreditation: The Michigan State Medical Society (MSMS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.


AMA Credit Designation Statement: The MSMS designates this live activity for a maximum of 5.5 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.


NPO Member – Free

MSMS Member - $195

NonMember - $275



West Bay Beach, A Holiday Inn Resort
615 E. Front St
Traverse City, MI 49686


Beth Elliott