Online Training Course

Prod ID: 434
Tips & Techniques for Managing Denials

Learn how to efficiently manage claim denials. Revenue cycle management expert, Taya Gordon, offers practical solutions for improving the denial management workflow in your practice.

CEUs

1

Length

45 min

Price

$119.00


There are many reasons a claim may be denied. Be sure that you understand the terminology of denials, remittance codes, the role of charge capture, and the impact of taxonomy codes. Of course, the best method for managing denials is to prevent them from occurring in the first place. The instructor discusses denial prevention goals and identifies proactive processes that will help you optimize prevention methods and ensure your claims denial rate stays under control.

Know how to determine the value of a claim denial and your rights and responsibilities when appealing them. Learn how to effectively communicate with payers to reach claim resolution.

Highlights:

  • Non-payment vs denial of payment
  • MDM documentation
  • Supporting medical necessity
  • Modifiers and bundling
  • Coverage determinations and carrier guidelines

Shawntea Gordon

MBA, FACMPE, CMOM


Shawntea "Taya" Gordon, MBA, FACMPE is the CEO of Atlas & Perpetua Healthcare Consulting, an organization dedicated to enhancing healthcare practices through fractional Chief Revenue Cycle Officer (CRO) services and comprehensive revenue cycle assessments. A recognized subject matter expert in healthcare compliance, organizational governance, process optimization, and revenue cycle management, Taya also serves on the CUMC Bergan Mercy Hospital Community Board.

With extensive experience in senior-level executive roles across private practices, collaborative institutes, and national care coordination organizations, Taya now focuses on educating and consulting healthcare leaders on operational excellence. Her expertise spans performance improvement, quality enhancement, risk reduction, and transitioning to value-based payment models. She also serves as an adjunct professor for the Howard University and University of the District of Columbia’s joint Revenue Cycle Management Course.

Taya is an active voice in healthcare thought leadership. She serves on the Medical Group Management Association's (MGMA) Government Affairs Council and E/M Workgroup, has co-authored two revenue cycle management books for MGMA, and contributed insights to HIMSS Voices of Innovation Publications, a collaboration with the Cleveland Clinic. She is also the co-host of RevDive, one of the nation’s higher-ranked healthcare podcasts.

A sought-after speaker and author, Taya frequently shares her expertise through organizations like HealthLeaders Media, the Practice Management Institute (PMI), MGMA, and Medical Economics. Her leadership has earned her recognition as the Past President of the HIMSS Nebraska Chapter, former Chair of the Membership and Corporate Development Maryland MGMA Chapter, and a Midland Business Journal "40 Under 40" Executives & Entrepreneurs Award Recipient (2019).

Taya is deeply committed to physician advocacy, community outreach, and healthcare process improvement. She has actively participated in government affairs and legislative committees, lobbying for healthcare reform, and supported community initiatives with Habitat for Humanity Omaha.

Participants will learn effective claim management techniques and how to effectively communicate with payers to reach claim resolution.
No prerequisites required.
Self-paced online program includes unlimited review of previously recorded instruction and the downloadable PowerPoint handout for 6 months.

Comments from past participants:

"I recommend this session. It offers a different way than I had previously looked at my denials, such as 0 to15 days vs the 30 days for claim status."

"Very informative and a great way to strengthen management skills. It provided good information that we touch on each day."

"This was a helpful reminder to ensure that our front desk staff are educated on the importance of full and accurate registration for clean claims."

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