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Successful Insurance Claims Processing


Spend less time fighting denials and more time ensuring that your front-end details are in order. The window to appeal a denied claim is getting smaller. This class will explain how to expedite claims and appeals and get paid.

Class Highlights:

  • Explanation and analysis of federal and commercial carrier guidelines
  • Overview of insurance plans and payment models
  • How to ensure that chart documentation supports claims submitted
  • Checklist of necessary patient information
  • Insurance verification and preauthorization
  • Working with pre-certification and authorizations for continued treatment
  • Proper use of the Advance Beneficiary Notice
  • Working with Medicare as a secondary payer
  • How to appeal inadequate reimbursements
  • Patient education and grievance issues
  • Procedure for capturing lost charges
  • Billing for pre-existing conditions
  • Coordination of benefits for covered/non-covered services
  • Working with general liability claims
  • Address common claims processing errors
  • Medicare’s Correct Coding Policy as it pertains to billing
  • Tips to avoid duplicate charge rejects
  • How to handle refunds for overpayments
  • Recovery Audit contractor claim review process
  • Know your rights and responsibilities during an audit

Target Audience

This training is designed for claims processors with limited experience, as well as physicians, consultants and clinical staff seeking a better understanding of carrier reimbursement.

What to Bring

Registration includes a digital course manual

Full Schedule


Program times are Central unless otherwise noted.

SessionDate TimeInstructor
1June 10, 202101:00-04:00Linda D'Spain
Fee: $199.00Register

Can't attend? Register anyway and we'll send you the recording.


CEUs:

PMI 3