• Describe Medicare beneficiary notices and when to issue.
• Assess the appropriate level of inpatient or outpatient care and best practices for documenting and billing patient services.
• Identify physician advisor roles and responsibilities within the health care team.

ACCREDITATION & CREDIT
In support of improving patient care, the American Board of Quality Assurance and Utilization Review Physicians (ABQAURP) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

This activity was planned by and for the healthcare team, and learners will receive 1 Interprofessional Continuing Education (IPCE) credit for learning and change.

Physicians
ABQAURP designates this enduring material for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nurses
This activity is designated for 1 nursing contact hour.

Osteopathic Physicians
This program is approved for Category 2 credit by the American Osteopathic Association.

Physician Associates
ABQAURP has been authorized by the American Academy of Physician Associates (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 1 AAPA Category 1 CME credit. Approval is valid until December 31, 2026. PAs should only claim credit commensurate with the extent of their participation.

This course is intended for Physicians, Nurses, and Other Health Care Professionals with appropriate CME / CE credit offered for each profession.

All participants must achieve a final assessment score of at least seventy percent (70%) for recertification and continuing education credits. You have 60 days to complete the course after ordering.

This activity is valid from April 16, 2026 through December 31, 2026. Original Release Date: September 12, 2025.

About the Authors:

Melissa Buchner-Mehling, MD, CHCQM, CPHYADV, FABQAURP
Dr. Melissa Buchner-Mehling finished Internal Medicine Residency and began practicing as a hospitalist in 2004. As an attending hospitalist she was actively involved with many committees in the hospital, including the Patient Safety Indicator Committee, Ethics Committee, Utilization Management Committee, Readmissions Committee, and Throughput Committee. She also was the hospital ICD10 Physician Champion and CDI Physician Champion. As a hospitalist she has volunteered for medical mission trips in Honduras and Kenya. Since her first days with Sound as a Medical Director of Advisory Services, Dr. Buchner-Mehling has found innovative ways to educate providers at the hospital. She is now the Associate Chief Medical Officer with Sound Advisory Services. A Diplomate and Fellow of ABQAURP, she currently serves on its Education and Physician Advisor Editorial Committees and has contributed as a subject matter expert in advanced physician advisor certification development.

Natasha L. Chen, MD, CHCQM, CPHYADV, FABQAURP
Dr. Natasha Chen is a board-certified internist and advanced physician advisor with over 16 years of healthcare leadership experience, including roles as Physician Advisor and Medical Director of Hospitalists. She has extensive expertise in utilization management, quality oversight, patient flow, and readmission reduction, having supported hundreds of hospitals nationwide and served in long-term physician advisor leadership within a large nonprofit health system. Dr. Chen has chaired utilization management committees and collaborated closely with quality and peer review teams on mortality and performance improvement initiatives. A Diplomate and Fellow of ABQAURP, she currently serves on its Education and Physician Advisor Editorial Committees and has contributed as a subject matter expert in advanced physician advisor certification development.

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