Denials Management: Optimizing Appeals Process for Successful Processing of Denials

One of the common functions in the medical revenue cycle for practices is adjudicating denials received from the insurance companies. Sometimes procedures or services are denied because they have been coded or billed incorrectly or in error, but it not uncommon that insurance companies will also deny claims in error. Whether the claim or the insurance company is in error contacting the insurance company in a timely manner is critical to ensure providers are reimbursed for services and procedures that were performed. Join this webinar to understand the insurance companies’ rules and guidelines and knowing where to find them is also important when reviewing claim denials.

Webinar Objectives

Everyone in a revenue cycle department has good intentions of taking time to review denials received, and make corrections or write appeals when necessary, however, very often denials are put on the back burner for everything else that can come up in the office. This webinar will give proven tips on creating a process in handling denials by the types of the denials you may be receiving efficiently.

Webinar Agenda

• Controllable reasons for denials
• Eligibility and pre-authorization
• NCCI
• NCD and LCD
• Insurance Carrier Polices
• Uncontrollable reasons for denials
• EOB’s and denials
• Denial tracking and trending
• Reimbursement
• Appeals
• On the Horizon

Webinar Highlights

• Reading denial and remark codes and understanding what they mean
• Know when billing a patient is the right thing to do
• Tips on processing denials in an efficient manner
• Applying insurance carrier policies to you claims to avoid denials
• References that can be used to defeat denials.
• Modifiers that can be used to avoid denials
• Documentation that is important to support your appeals
• The difference between a denial and remark code.

Who Should Attend

Coders, Collection and Reimbursement staff, claims processors, managers, administrators, billers