Denied Claims Appeals 2014 - Strategies and Tactics for Retrospective Denied Claims Appeals

Overview: In this program, the presenter discusses strategies and tactics for better outcomes on retrospective denied claims appeals. She describes how to weave together the clinical, technical, and legal components for effective denials management and improved revenue cycle management. Done correctly, providers can positively impact a hospital’s financial bottom line.
The presenter will share sample form letters and templates that will bolster your appeals arguments and provide the audience with tips and tools for how to structure an integrated, effective process to achieve the best outcomes
Areas Covered in the Session:
Understand how to effectively establish a denials management integrated process including team composition, workflows, processes and procedures.
Identify specific denials management challenges and ways to overcome them
Review the importance of accurate data collection and analysis
Understand how to prevent future occurrences
Who Will Benefit:
Contract Analysts And Negotiators
Revenue Cycle Managers And Directors
Billing Staff
Refund Analysts And Processors
CFO's And Patient Financial Services Managers
Outpatient Clinic And ASC Managers
Healthcare Business Managers
Hospitalists And Private Practice Physicians
Medical Group Administrators
Physical, Occupational, Speech Therapists
Behavioral Healthcare Providers
Independent Nurse Practitioners
Home Healthcare Providers
Medical Equipment And Supply Providers
Pharmaceutical Manufacturers
ACO Executive Directors
Members Of UR Committees
Case Managers
Compliance And Audit Professionals
Health Information Managers
Hospital Board Members
Consultants
Maria K Todd Contracting strategy and organizational development (OD) for integrated health delivery systems has been a passion and a pursuit of our workshop leader since 1983. Maria Todd started her career in health administration in the multi-specialty group practice setting, and later designed and developed more than 150 IPAs, PHOs and MSOs during the Clinton Administration. In 1995, McGraw Hill and HFMA co-published her book, The Managed Care Contracting Handbook, and then in 1997, her book, title IPA, PHO, MSO Development Strategies was released. Both how-to books were written to help providers develop reimbursement strategies and design, plan and launch integrated health systems. Each sold more than 4000 copies. Considering there are about 7500 licensed hospitals in the USA, that number is considered a smashing success. In 2009, the sequel to ththe Contracting Handbook was updated and in 2012, her book, Physician Integration and Alignment: IPA, PHO, MSO ACOs and Beyond, was published by CRC | Productivity Press Both are once again, breaking industry sales records. She's been analyzing and negotiating managed care contracts and practicing organizational development as a facilitator since the 1980s.
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