How To Manage Denials For Efficient Reimbursement

Conference Materials (Password Required)

This webinar will be focusing on Denial Management and include some tools and resources to build a great foundation for your medical office or hospitals to combat claim denials.

Knowing how to identify specifics of denial situations and how to avoid them in the future is very crucial element. Learn the top tricks to ensure you are paid appropriately. Gain and acquire knowledge of how to work with payers and patients and how to help them understand their insurance benefits. Medical necessity denials will be a thing of the past; we will go through some specific examples of notes and how to spell out medical necessity to ensure you are paid the first time.

After attending this session, participants will become aware of how to understand insurance contracts, don’t get lost in the wordy contracts and gain experience of how decipher hidden meanings. Discover tips and tricks of getting authorizations even when out of network (OON). Follow up of claims with ease as you will learn how to be extra aggressive with payers to get the results you need. You will also be comfortable with appealing claims and proving medical necessity for claims.

Learning Objective:

• Know the difference between Rejections vs. Denials
• Know how to Read an EOB and ERA denials
• Know how to Run an A/R Report
• Know how to Analyze Reports for Trends in your Denials
• Know how the Appeal process works for different insurance company
• Know where to go to find appeal information for different insurance companies

Areas Covered in the Session:

• Revenue cycle management circle of reimbursement
• Where to start when you get a denial- EOB, ERA
• Clues in you’re A/R reports are found by running by specified criteria, depending on what you are looking for. Dates, insurance companies, providers, office staff
• The steps of an appeal process, in order so you avoid other denials during appeal process
• Sending the appeal with information from the insurance company that you can find on their website
• Digital technology (portals) and the importance for appeal process, and claim information
• Resources from reputable sources that will help with appeal

Suggested Attendees:

• Billers
• Coders
• Administrators
• Medical Officer
• Practice Manager
• Medical Assistants
• Providers
• Claims Processors
• Collectors
• Payment Posters
• Anyone involved with professional fee for service billing and coding

Presenter Biography:

Misty Haralson CPC, COC, CPMA is the founder of Medical A/R Services. She has 15 years of Full Revenue Cycle Management Experience, including Coding, Auditing, and detailed analysis of claims data for appropriate and efficient reimbursement. She takes pride in helping small physician offices reach their peak potential of reimbursement through loving their A/R reports. She is part of the National Society of Certified Healthcare Business Consultants (NSCHBC) and the American Academy of Professional Coders (AAPC).

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