Documentation Fundamentals: Strategies to Avoid Malpractice Claims

Consistent, current, and complete documentation in the medical record is an essential component of quality patient care. Failure to properly document a patient encounter can lead to significant liability issues for healthcare providers. Careful documentation improves the provider-patient relationship, enhances reimbursement, and is a leading factor in determining whether a plaintiff’s attorney will pursue a potential medical malpractice claim. With the enactment of the 21st Century Cures Act, patients now have easy access to their medical records, empowering them in healthcare decision-making while increasing accountability for care providers.

Join us as Risk Management consultants from MLMIC Insurance Company review the fundamentals and common liability issues associated with documentation, discuss the impact of the 21st Century Cures Act, and offer strategies to improve care documentation quality and reduce potential liability exposures.

Insurance Audits and Overpayments

This webinar will delve into the complexities of insurance payor audits and overpayments targeting physicians. We will cover the typical audit process from initial chart demands and claim reviews to overpayment assessments, appeals processes, and extrapolation. We will discuss appeal strategies, including position statement submissions, utilization of experts, and leveraging legal counsel and self-audits early on. Practical tips will address preventing overpayments via proactive compliance and navigating recoupment limitations.

Upon completion, participants will be able to:

• Identify the fundamental aspects of appropriate medical record documentation
• Discuss how documentation impacts medical malpractice litigation
• Understand how the 21st Century Cures Act impacts the physician-patient relationship
• Apply best practice strategies to improve care documentation and reduce professional liability claims

Speakers

David N. Vozza, Esq.

Devotes his practice to health care and litigation, defending professionals in audits, disciplinary actions, and regulatory compliance. General Counsel to the Medical Society of the State of New York.

Shelly L. Kriete, BS, CPHQ, CPHRM

Senior Vice President, Risk Management at MLMIC with over 40 years of experience in quality and risk management leadership.

Donnaline Richman, BSN, MN, Esq.

Attorney at MLMIC Legal Department with 38 years of expertise in healthcare law and risk management.