2015 Annual Training Conference & Anti-Fraud Expo
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Endoscopic Sinus Surgery
(
Room
Seaport F
)
19 Nov 15
8:15 AM
-
9:30 AM
Tracks:
Clinical Issues for the Health Care Fraud Investigator
Speaker(s):
Fred Holt, MD, JD, AHFI, Managing Member, Medical Affairs Partners, LLC
The popularity of endoscopic sinus surgery has soared among Otolaryngologists since its introduction in the 1980s. Now balloon dilatation of the sinus openings has made richly-reimbursable sinus operations possible in the office setting. Abuse of these operations has proliferated. This session will teach the participants what these procedures are, why they are so popular, and how they are causing payors unnecessary loss. Faculty will show how one plan recognized the problem and brought it under control though the use of the adaptation of a strong evidence base into the plan's own rule set with the input and buy-in from the local ENT physician community. Attendees will leave the class armed with a game plan to see whether their plans are impacted and, if so, how to gain control of the problem.
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