Mastering Claim Denials: Unlocking Revenue Hidden in the Appeals Process

A part of the revenue cycle that has gathered a lot of attention in the last few years are claim denials.  Denials can become a very complex and frustrating because they aren’t always appropriate, which makes many question how the insurance carriers can deny claims erroneously.  It is important that part of each practice’s revenue cycle include addressing denials with tracking, reviewing, and appealing denials when they are inappropriate.  This webinar will discuss tips on implementing and handling denials to ensure that the practice is not losing money that should be collected from the insurance companies.

Webinar Objectives

Many offices have difficulty finding the time to work denials because of other tasks that seem to be of more priority and yet many denials are received in error and will be money lost if they are not solved in the timely filing period.  When denials are worked by a process, and the burden is shared between many in the office, denials are not so much a burden but an important part of the revenue cycle process.

Webinar Agenda

• Understanding denial and remark codes
• Determining staff involvement
• Investigate what help can come from automation in the PM system
• Template letters for like denials
• Creating metrics to be able to see a new denial

Webinar Highlights

• Reading explanation of benefits
• Utilize insurance carriers forms and processes for reconsideration and appeal
• Track denials to be aware of unannounced policy changes and make corrections to avoid future denials
• Determine the capability of the PM system to assist or the creation of a manual process
• Assign different parts of denial management to qualified staff
• Have a successful process so that all claims that should be paid, are paid.

Who Should Attend

Coder, Biller, Collection staff, Managers, Supervisors, Administrators, Directors