Prod ID: 354Whether your medical practice is submitting claims to government or commercial insurance carriers, or managed care organizations, your healthcare claims must be 100% accurate to be successfully processed and reimbursed.
1
68 min
$119.00
This fast-paced overview of medical insurance and claim related guidelines will teach a novice employee about health insurance plan types, guidelines, and review the steps to ensure proper reimbursement. It is an excellent refresher for more experienced staff. Learn details about managed care contracting, the levels of participation, benefits verification, payment processing, covered services, how long it takes to process a claim, and how the appeals process works.
Other points covered include:
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Jan HaileyMHL, CMC, CMCO, CMIS, CMOM, CMCA E/M |
Jan Hailey has more than 30 years of experience in healthcare. She is proficient in administration, coding, and billing roles, and teaches medical office professionals around the country how to excel in their careers. Jan has also been instrumental in the development of PMI's Workforce Initiatives program.
Jan's affinity for teaching has helped countless healthcare providers and medical office professionals over the years. During her expansive career, she has served as Director of Quality for Saint Joseph Physician Network located in Mishawaka, IN, and Director of Care Management with Select Health Network, an entity of Saint Joseph Health System. As Care Management Director, Jan led the physician network and comprehensive interdisciplinary team across the health system working closely with providers, management, staff, community, and payers to develop strategies for process improvement, gap closures, and patient experience. She developed a documentation improvement program and a Hierarchical Condition Category (HCC) coding education program to predict future healthcare utilization by accurately reporting patient complexity.
Prior to joining Saint Joseph, Jan was the Director of Quality, Coding, and Compliance for one of the largest health systems in Northern Indiana. She has a Master of Health Leadership and four professional certifications in office management, coding, insurance processing, and compliance. She is a member of WPS Government Health Administrators (Medicare) Provider Outreach and Advisory Group.
Comments from past participants:
"It helped me to understand the different levels of value based care."
"Excellent content & instruction."
Certified Medical Insurance Specialist (CMIS)®
Successful Insurance Claims Processing