Appeals, Refunds and Recoupments
|Instructor:||Lisa Maciejewski-West, CMC, CMIS, CMOM, MCS-P|
||Two instructor-led, 90-minute live online training sessions: March 22 and 29, 12 noon to 1:30 p.m. Central (10 a.m. Pacific, 1 p.m. Eastern). Set firstname.lastname@example.org as a Safe Sender in your email server to ensure access to login information.
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 medical office professionals working in a reimbursement role.|
|Materials:|| Registration includes a digital course manual|
|| 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.
This course will explain your rights and responsibilities when appealing claim denials. Receive tools and expert guidance on how to second-guess denials and recoup dollars rightfully due to the provider. The instructor will address questions head-on and provide new insight and tools to help billing staff successfully handle all your appeals, refunds and recoupment requests.
- Understand the reasons claims are delayed/denied
- Efficient methods for combating denials
- Modifiers, bundling, downcoding, and other situations that cause a claim to be rejected
- Appealing bundled or downcoded claims
- Working within claim guidelines to avoid further delays
- Write results-oriented appeal letters
- Effectively respond to inappropriate recoupments
- Handling payment inconsistencies
- State and Federal Guidelines for refunds/recoupments
- Guidance on Prompt-Pay laws
- Troubleshooting repeat denials
- Accessing legal guidance if needed
Continuing Education Units (CEUs)
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.
About the Presenter
Lisa has been involved in the medical billing, management and consulting field since 1982. In 2006, she founded Gold Star Medical Business Services, an award winning company that provides remote billing services for physicians in small to medium sized individual and group practices. Prior to starting Gold Star Medical, she worked for one of the largest Practice Management consulting firms in the country.
For 10 years, she has consulted with hundreds of doctors as a practice management coach, and spoken at over 100 seminars throughout the United States, both as a teacher and motivational speaker. Lisa also provides comprehensive practice management consulting, credentialing and compliance auditing services.
Lisa holds three PMI certifications and is a board certified MCS-P (Medical Compliance Specialist -Physician). She is PMI’s Director of Business Development for the West Central Texas region. She is also an adjunct instructor with the Angelo State University Small Business Development Center, and teaches a variety of business classes to new and prospective business owners.