Case Management Strategies to Prevent Third-Party Payer Denials

Key Strategies for Reducing and Preventing Third Party Payer Denials

Event Information
Product Format
Live Audio Conference
Toni G. Cesta, Ph.D., RN, FAAN
Conference Date
Add to my calendar   Thu, Oct 04, 2018
Aired Time
1 pm ET | 12 pm CT | 11 am MT | 10 am PT
60 minutes
Product Description

Make Case Management Your Denial Prevention Tool

You may find it tempting to throw up your hands and simply accept the fact that denials are inevitable. Sure, the causes of denials are complex and therefore require complex solutions. But did you know that case management can be your secret weapon to prevent and decrease third-party payer denials?

Learn how in the information-packed audio presentation by healthcare compliance expert Toni Cesta, PhD, RN, FAAN, who will provide you with proven solutions for reducing and averting denials, as well as strategies for analyzing your hospital’s denial rate. You need to put into place proactive and hard-wired processes that engage your entire interdisciplinary team and your case management department.

After attending this audio event, you will understand the case manager’s role in providing and maintaining strategies for reducing denials, as well as what elements within and outside your hospital are contributing to denials. Learn the key roles for avoiding denials, including the roles of the interdisciplinary care team. Also, you’ll walk away with dynamic case management strategies for denial prevention and management.

Session Highlights

This program will teach you how to:

  • Utilize key case management roles that impact denials.
  • Identify types of clinical reviews and categorize denials.
  • Carry out effective denial management techniques and processes.
  • Outline the roles of team members and stakeholders.
  • Understand the definition of revenue cycle and the revenue cycle process steps.
  • Gain a better understanding of medical necessity and payer expectations.
  • Spot the crucial steps in care coordination and the discharge planning process where denials can occur.
  • Protect against the common causes for denials regarding case management and third-party payers.

Who Should Attend

  • Directors of Case Management
  • Compliance Officers
  • Directors of Finance
  • RN Case Managers
  • Directors of Quality Management
  • Directors of Social Work
  • Social Workers
  • Hospitalists
  • Physician Advisors

Ask a question at the Q&A session following the live event and get advice unique to your situation, directly from our expert speaker.

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About Our Speaker

Toni G. Cesta - Healthcare Case Management Expert

Toni G. Cesta, Ph.D., RN, FAAN is Partner and Health Care Consultant in Case Management Concepts, LLC, a consulting company which assists institutions in designing, implementing and evaluating acute care and community case management models, providing on-site education to case management staff, and strategies for assisting health care organizations in improving their case management department’s efficiency and effectiveness.

The author of nine books, and...   More Info
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