Strategies To Avoid Denials And Submit Successful Appeals

All members of the ob/gyn practice should take interest in the claims process to help avoid first time denials and ensure that the appeals process goes quickly with positive results.

The health of the ob/gyn practice is very dependent on income flowing in at a steady and consistent rate.  When services are denied, this flow slows down and more resources and staff time must be spent in appealing the denial.  

In this 60-minute event with Melanie Witt you will learn the reasons for most denials and tips on how to avoid them as much as possible.  For those denials that cannot be avoided, but for which an appeal is possible, you will get advice on how to approach each type of denial, and what tools you can use to put your best foot forward with the payer. 

Take a look at what’s covered:

• Most payers have more than 50 denial codes.  If you know what they mean you can understand how to prevent them.  Learn about the major causes of claim denial and how to avoid them
• Not all denials are due to data entry errors.  Learn when staff and physicians must be aware of to avoid denials or decrease them.
• Are you using modifiers effectively to avoid denials?  Let’s review the ones that work and why.
• When is a denial not recognized as one?  When it is hidden.  Be sure you know these 3 factors that will impact your bottom line.
• Claims denials can occur even in the best run practices.  Find out the best questions to ask to ensure that staff and providers are working together to create the “clean” claim that is always paid in a timely manner.
• Appealing a claim takes time.  Learn how to be proactive in preparing and sending appeal letters to the right person for the right response that addresses a specific denial reason.  Hint: Pay me or else is not an effective tactic.

Who should attend? Coders, billers, practice managers, physicians, non-physician practitioners

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