Physician Medical Record Documentation: The Backbone for Verifying Medicare Medical Necessity

Ames, IA US
February 18, 2015

Mary Greeley Medical Center Grand Rounds is a multi-disciplinary clinical activity which serves to maintain, develop, or increase the knowledge, skills, and professional performance and relationships that a physician uses to provide services for patients, the public or the profession.  

Target Audience

Physicians, mid-level providers, nurses and healthcare administrators.

Professional Practice Gap

  • Staff and hospital leadership are often not aligned in compliance efforts
  • Staff has not been clearly educated on the importance of correct medical necessity determinations
  • Limited resources to manage time and workload consistently and effectively

Learning Objectives

  1. Identify the various national programs that CMS has initiated to audit hospitals and providers to ensure proper Medicare billing and claim compliance.
  2. Understand the vital importance of a consistent Utilization Revtcw {UR) process, plus describe the steps used in a standard compliance review process.
  3. Summarize critical pieces of document:ltion needed to verify medical necessity.
  4. Define the Two-Midnight Rule.


Kurt Hopfensperger, MD, JD
Senior Director of Audit, Compliance and Education Executive Health Resources




  • Dr. Hopfensperger is an employee of Executive Health Resources.

CME Committee

  • Dr. Brenda Burrough discloses she is a principal investigator in an Amgen research trial.
  • No member of the Mary Greeley Medical Center CME Committee who planned this activity, including Dr. Burrough, has any financial relationship to disclose relating to the content. 

The content and selection of speaker(s) is the responsibility of the Mary Greeley Medical Center for Continuing Medical Education Committee.

Continuing Education Credit

  • DO: Des Moines University is accredited by the American Osteopathic Association (AOA) and approves this live activity for 1.0 Category 2-A CME credit(s).
Course summary
Available credit: 
  • 1.00 AOA Category 2­A
Course opens: 
Course expires: 
Event starts: 
02/18/2015 - 12:00pm CST
Event ends: 
02/18/2015 - 1:00pm CST
Mary Greeley Medical Center
Bessie Myers Auditorium
1111 Duff Avenue
Ames, IA 50010
United States

Available Credit

  • 1.00 AOA Category 2­A


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