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Payer Denial and Appeal Management


About this program


Back by Popular Demand. Rebroadcast of a PMI favorite.

Insurers work hard to protect their bottom line, and providers are working just as hard to be paid for their services. In some offices, underpaid, rejected, or denied claims can climb to $100,000 per month, according to the American Medical Association. And, if an insurance provider underpays a claim, statistics show that it is up to 35% lower than the original contract amount. Revenue cycle staff training is critical for healthcare organizations seeking to capture their revenue collected for healthcare services provided.

Preventing claim errors is essential to combat time-consuming, costly claims resubmissions. This training helps your billing and claims processors, coders, auditors, providers, managers, consultants, and anyone seeking solutions and for claim rejections and denials get to the root of the problem and proactively prevent errors before they go out the door.

It is necessary for billing staff to stay current on industry developments, not only for compliance issues but also to protect your bottom line. Promoting ongoing education is a win-win for the staff and your practice. Completing this training will help build an attentive, competent and productive team trained to deal with denials and rejections, and reduce errors that could make your office vulnerable to fraud and abuse.

Learners will be able to:

  • Identify when to raise a physician query before encountering a denial
  • Recognize methods of compliance to support the denial management process
  • Become aware of the insurance/ payer guidelines to avoid denials
  • Reduce the claims rejection encounters by the facilities
  • Discover ways to improve the coding and billing process leading to improved Revenue Cycle Management (RCM)
  • Share resources and new information with the whole team