Prod ID: 540Navigating the complex landscape of insurance denials, overpayments, and recoupment requests is no small task. Discover valuable resources and learn proven strategies for success. This practical training program will empower you to protect revenue, maintain payer relationships, and avoid costly compliance missteps.
1
63 min
$119.00
Gain the tools and knowledge needed to confidently manage appeals, issue compliant refunds, and respond effectively to payer recoupments. Explore common reasons for denied, delayed, or partially paid claims. Identify the key elements of an effective denial management program and understand what is required for a successful appeal. Learn when and why refunds are required and how to respond to recoupment requests.
Key objectives for this session 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.Â
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:
Appeals, Refunds and Recoupments
Effectively Manage Claims Denials and Appeals
Tips & Techniques for Managing Denials