Practice Management Institute  

Improving the business of medicine through education.

 
Follow Us On:            






Home > Audio Learning Center > Successful Insurance Claims Processing

Successful Insurance Claims Processing

Instructor:Linda D’Spain, CMPE, CMC, CMIS, CMOM, CMCO, CMCA-E/M
Schedule: Two instructor-led, 90-minute live online training sessions: May 26 and June 2, 12 noon to 1:30 p.m. Central (10 a.m. Pacific, 1 p.m. Eastern).
NOTE: Live session attendance is optional. See the materials section below for more information. Sessions are recorded and available in PMI’s Online Training Center 2-4 days after the last recording date. Registrants receive access to the session recordings and digital course manual for 6 months.
Online Course Fee:$199 per person*
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.
Materials: Registration includes a digital course manual
CEUs: PMI certified professionals earn 3 CEUs, emailed with certificate of completion

*This Online Course is not included as part of the Total Access webinar subscription package.

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

Continuing Education Units (CEUs)

PMI CEU APPROVED Earn 3 PMI CEUs for attendance at this program. Practice Management Institute grants CEUs for its certified professionals based on total number of instructional hours (1 CEU per hour of classroom instruction). CEUs may be applied to annual recertification requirements, as directed in the certification renewal requirements for your credential(s).

If you are seeking CEU credits for other certifications or organizations, please contact your organization for pre-approval and credit guidelines. A certificate of attendance will be provided.


pmimd instructor

About the Presenter

Linda is President of her medical practice management consulting firm, D'Spain Consulting. She travels the country conducting national seminars, workshops and webinars and consulting with physician practices, hospitals and medical societies on healthcare reimbursement, documentation guidelines, procedural and diagnostic coding, financial management, human resources, medical office management and compliance with fraud and abuse, OSHA, and HIPAA. She has also served as an Independent Review Organization (IRO) for the Office of the Inspector General and consulted for the Texas Medical and Dental Boards.

With more than 30 years of experience in medical practice management, Linda has managed cardiology, cardiothoracic, vascular surgery, physical therapy, orthopedics, pediatric orthopedics, gynecology and reproductive endocrinology and large multispecialty group practices. She maintained broad responsibilities in business and clinical operations, financial management, governance and organizational dynamics, human resource management, marketing, customer service, compliance, information system management, mergers and acquisitions and risk management.

Linda has attained all five PMI certifications. She also has a degree in Business Administration and is a Board Certified Medical Practice Executive through the American College of Medical Practice Executives, a member of the San Antonio Medical Group Managers Association (MGMA) and has served as an advisory board member with PMI.




tel: 1-800-259-5562 | fax: (210) 691-8972 | info@pmimd.com

8242 Vicar Dr., San Antonio, TX 78218

© CPT is a registered trademark of the American Medical Association. All rights reserved.
©2020 Practice Management Institute® |  All rights reserved.