2026 Insurance Claim and Policy Updates

Description

This webinar provides a practical and comprehensive overview of the Medicare and commercial insurance claim and policy updates impacting healthcare organizations in 2026. Attendees will gain clarity on coverage determinations, coding edits, reimbursement methodologies, and payer-specific policies that directly affect claim outcomes.

The session explores National and Local Coverage Determinations, the Medicare Coverage Database, National Correct Coding Initiative edits, medically unlikely edits, and the Medicare Relative Value File. In addition, participants will learn how to locate and apply policy updates from major commercial payers including UnitedHealthcare, Humana, and Aetna. The program concludes with practical guidance for organizing payer policies, educating staff, disputing claims, and reducing preventable denials.

Webinar Highlights

• Understanding the difference between National and Local Coverage Determinations (NCDs and LCDs)
• How to navigate and use the Medicare Coverage Database effectively
• Applying ICD-10 diagnosis codes to coverage and medical necessity requirements
• National Correct Coding Initiative (NCCI) edits and how they affect CPT® and HCPCS reporting
• Medically Unlikely Edits (MUEs) and unit limitations
• Using the NCCI Policy Manual and add-on code edits
• How the Medicare Relative Value File impacts reimbursement
• Where to find and interpret UnitedHealthcare, Humana, and Aetna policies and updates
• Best practices for organizing payer policies and communicating updates internally