June 29 - Medical Necessity Webinar Series Part 3- Practical Application of Medical Necessity: Understanding Prior Authorization Process, Requesting Authorizations, and Denials and Appeals
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Availability
No future session
Expires on 07/29/2022
Cost
$0.00
Credit Offered
1 CME (AMA) Credit
1 CME (Other) Credit

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Wednesday, June 29, 3:00 – 4:00 pm ET
Medical Necessity Webinar Series Part 3- Practical Application of Medical Necessity: Understanding Prior Authorization Process, Requesting Authorizations, and Denials and Appeals.

Course Description:

The Catalyst Center and the National Coordinating Center for the Regional Genetics Networks, two programs supported by the Health Resources and Services Administration, are pleased to announce a three-part webinar series to help the genetics community better understand how they can navigate medical necessity. This webinar series will provide information about medical necessity through the lens of genetic cases.

Learning Objectives:

 

At the conclusion of this session, participants should be able to:

  1. Explain what it means when a prior authorization is denied
  2. Identify where to begin the appeal process
  3. List the steps in the process for an appeal
  4. Describe options if an appeal is denied

Target Audience:

Healthcare Providers, Public Health Professionals, Individuals/Families

 

The Catalyst Center (Grant U1TMC31757) is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award totaling $500,000, with no financing by nongovernmental sources. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by HRSA, HHS or the U.S. Government.

 

The National Coordinating Center for the Regional Genetics Networks is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under Cooperative Agreement #UH9MC30770 from 6/2020-5/2024 for $800,000 per award year. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.

Contributors:  

Erin Beaver, MS, CGC

Licensed Certified Genetic Counselor

Missouri Baptist Medical Center

 

Julie Kaylor, MS, CGC

Director, Medical Affairs, Managed Care

Guardant Health

 

Nicole Guysi

Family Leader

Demeatrice Nance, CCHW

Research Coordinator

Pediatric Institute

Cleveland Clinic Children’s

 

Tammy Jones

Program Coordinator

Genetic Metabolic Nutrition Research & MNT4P Program, Emory University

Jeff Schiff, MD, MBA

Senior Scholar

AcademyHealth

CME Educational Credits:

Accreditation

The American College of Medical Genetics and Genomics is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

 

Credit Designation

The American College of Medical Genetics and Genomics designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

 

Claiming your Educational Credits

Complete the activity and carefully complete the evaluation form. The deadline to claim educational credits is within 30 days from the date of the activity. Educational credit requests after this date will not be accepted.

Accredited Continuing Education Financial Disclosure

The American College of Medical Genetics and Genomics (ACMG) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide Accredited Continuing Education (ACE) for physicians. ACMG is an organization committed to improvement of patient care and general health by the incorporation of genetics and genomics into clinical practice.

ACMG has implemented the following procedures to ensure the independence of ACE activities from commercial influence/promotional bias, the Accreditation Council for Continuing Medical Education (ACCME) requires that providers (ACMG) must be able to demonstrate that: 1) everyone in a position to control the content of an ACE activity has disclosed all financial relationships that they have had in the past 24 months with ineligible* companies; 2) ACMG has implemented a mechanism to mitigate relevant financial relationships; and 3) all relevant financial relationships with ineligible companies are disclosed to the learners before the beginning of the educational activity. The learners must also be informed if no relevant financial relationships exist.
*Ineligible companies are defined as those whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

 

ACMG Education Policies

Please review the policies below regarding the ACMG Education program

 

All of the relevant financial relationships listed for these individuals have been mitigated.

Name

Program Committee Member

Presenter
Panelist
Moderator

Peer Reviewer

Financial Disclosure Relationship/Company

Baughman, Allyson

X

   

Nothing to disclose

Beaver, Erin

X

X

 

Nothing to disclose

Caisse, Molly

X

 

 

Nothing to disclose

Comeau, Meg

X

 

 

Nothing to disclose

Ginsburg, Susanna

X

 

 

Nothing to disclose

Guysi, Nicole

X

X

 

Nothing to disclose

Jones, Tammy

X

X

 

Nothing to disclose

Kaylor, Julie

X

X

 

Employment and Stock, Guardant Health

Lyon, Megan

X

 

Nothing to disclose

Nance, Demeatrice

X

X

 

Nothing to disclose

Schiff, Jeff

X

X

 

Nothing to disclose



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