Denial Management In and Out of Network

Event Information
Product Format
Prerecorded Event
Conference Date
Wed, Oct 10, 2018
60 minutes
Product Description

Turn the Burdensome Appeals Process into a Profitable One

Let’s face it: Claims denials mean money lost and headaches gained. And the appeals process is no walk in the park. But you can ease the burden with an effective denial management workflow.

Do you maximize the revenue earned on appeal? Do you use each claims denial to pinpoint improvement areas to curb future losses? If not, now is the time for a revamp. Join healthcare billing veteran Stephanie Thomas to learn how to stop being reactive and add some proactivity to your claims denial management—for both in- and out-of-network services.

In this program, Thomas will teach you to identify and eradicate recurring claims errors that are leading to unnecessary denials for your facility. Plus, she’ll make you aware of network-specific claims mistakes that payers are sure to notice. You’ll also gain a clearer understanding of the proper use of claims review forms such as pre-authorizations and insurance verifications.

Thanks to specific examples of good (and bad) denial management work and various denial types (e.g., demographics, authorization, medical necessity, out-of-network, and others), you’ll leave this session with a better grasp of how to handle any denial situation. You’ll also be equipped to establish safeguards to limit denials and increase payment rates. Far from a generic presentation, Thomas will present the specific tools you need to improve outcomes for your practice.

Session Highlights

This program will teach you how to improve your billing process by:

  • Working through your denials to maximize results and revenue
  • Using pre-authorizations, insurance verifications, and other documentation correctly
  • Understanding how to approach all denial types: demographics, authorization, medical necessity and out-of-network
  • Taking advantage of PM software and clearinghouse resources
  • Identifying trends to prevent denials and increase appeals success

Session Agenda

  • Types of denials
  • Denial examples
  • Levels of appeal
  • Medicare appeal process
  • Writing strong appeal letters

Who Should Attend

  • Billing Professionals and Managers
  • Coders
  • Authorization Staff
  • Office Managers
  • Administrators

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

Stephanie Thomas

Stephanie Thomas is the Billing Director for CE Medical Group, a third party billing and consulting firm. Stephanie has been in the medical field for nearly 20 years. Her experience includes private practice administration, medical billing for several specialties, practice management consulting for numerous physicians and ASC’s across the nation.

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