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Stop AI Downcoding of High-Level E/M Claims Before It Drains Your Revenue

By - Maya Turner, CPC, CPB, CPMA, CPCO, CFPC, CRC, CPC-I (AAPC Approved Instructor)

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Major payors are utilizing AI to intercept and automatically downcode your high-level E/M office visit claims (99204-99205; 99214-99215) and underpaying you for these critical services.

The only way to protect your practice from automated payor reimbursement reductions of your high-level E/M services is to modify your billing processes. Implementing the correct changes is the key.

Stop E/M Level Reductions

You don’t have to accept downcoding and reimbursement cuts for your high-level E/M claims. Maya Turner, CPC, CPB, CPMA, CPCO, CFPC, CRC, CPC-I (AAPC Approved Instructor), can show you how to fight back and win.

Maya will present a 60-minute online training session that provides proven tactics to help you fight back against payor automated downcoding of your E/M claims.

Maya’s session will help you more successfully identify, track and appeal these payor downcoded claims to help you recoup the reimbursement that is rightfully yours. Check out just some of the practical advice you’ll receive during this training:

  • Track payment variances to quickly uncover and overturn downcoded claims
  • Justify high-level E/M services with documentation language payors want
  • Fight back and win against remittance advice codes M85 and N610
  • Reclaim revenue by tracking systematic patterns in Level 4 / 5 service code reductions
  • Use a payor EOB downcoding justification codes against them
  • Uncover “hidden” E/M downcoding and get your original code reinstated
  • Overturn more E/M downcoded claims with proven appeal letter language
  • Implement utilization variance payment tracking to identify payor downcoding
  • Utilize ICD-10-CM complexity to support E/M levels and get appeals paid
  • Know when to invoke the “Prudent Layperson Standard” in your appeals

Stop Losing E/M Revenue to Downcoding

The cumulative financial impact of consistent AI-driven downcoding of your high-level E/M services is substantial. Not to mention unfair, considering you provided the high-level service and deserve to be paid for it. You can win the battle against payor AI downcoding if you know how, which is exactly what you’ll learn from this training

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Speaker Detail

Maya Turner, CPC, CPB, CPMA, CPCO, CFPC, CRC, CPC-I (AAPC Approved Instructor)

With nearly 30 years of experience in medical coding, auditing, compliance, and revenue cycle management, Maya Turner is a nationally recognized expert and educator in the healthcare compliance community. She holds multiple AAPC certifications and is an AAPC Approved Instructor, bringing both technical expertise and real-world insight to her training sessions. Maya’s specialties span multi-specialty physician practices, primary care, hospitalists, telehealth, inpatient services, and skilled nursing facilities. She is a frequent speaker at national conferences including AAPC’s HealthCon and the HCCA Compliance Institute, and serves on the ACDIS Leadership Council. Her work has been published in AAPC and HCCA journals, further establishing her as a trusted authority on complex coding and compliance issues. As Managing Director of Turner Expert Consulting Services, LLC, Maya provides specialized training and consulting to healthcare organizations across the country. Known for her clear, engaging teaching style, she helps providers and practices simplify complex compliance challenges and maximize revenue integrity.

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