Don't let claims issues drain your practice. Resolve them at the source. Strengthen your practice's financial health by addressing claims inefficiencies head-on.
Learn how to identify erroneous billing procedures that result in denials and rejections, how to troubleshoot denials, and work within claim guidelines. Review common reasons insurance companies deny, delay, or partially pay a claim. Adopt a proven 10-step approach and solve the denial management problems in your practice. Analyze and investigate unpaid claims and effectively communicate with payers to gain results. Don’t delay! Protect your profits by proactively resolving claims roadblocks.
Learning objectives;
1. Reduce denials by mastering fundamental claims guidelines and identifying red flags
2. Streamline your appeals process through effective vetting and claim correction
3. Optimize reimbursement by understanding NCCI edits, medical necessity, and prompt pay laws
4. Protect your practice with compliant billing policies that eliminate frequent mistakes
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Shawntea Gordon
MBA, FACMPE, CMOM
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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 how to gain results when addressing unpaid claims plus gain tips for identifying and resolving billing problems before claims go out the door.
No prerequisites are required. The content covered in this course assumes basic knowledge of outpatient billing and carrier reimbursement.
Enhance your understanding of the types of denials, remittance codes, bundling and CCI edits. Know how to create a tracking system to help minimize problems, avoid lost revenue, and reduce audit risk. Find out how to monitor payer policies, resolve denials, and implement efficient methods for monitoring claims and finding resolution. Master preventing billing problems before claims go out the door. Implement processes that will help you to ensure your claims denial rate stays under control.
Prod ID: 549