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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

See the full course description here.

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 a live session? Register anyway and you'll receive a link to the recording by the next business day.


CEUs:

PMI 3