Whether the issue is inadequate payment, denial or
rejection, participants will return to the office well-equipped to handle the
5 Reasons to Attend
- Know what you should be getting paid and pay
attention to your denial reason codes on EOBs.
- Get the latest information on Medicare appeals process and amounts in controversy, including sample appeal letters.
- Discover how persistence and familiarity with federal and state laws will provide the necessary guidance needed when appealing claims.
- Understand the claims rejection methodologies
that third-party payers use to deny claims.
- Review State Specific Guidance on "Prompt-Pay Laws" and accessing legal guidance, when needed.
Protect the practice's bottom line with specialized appeals
training for your billing staff.
When correctly-submitted claims are inappropriately reduced,
delayed or denied, it is imperative to appeal claims in a timely manner with as
much supporting documentation as possible. It is important to properly write an appeal for your claim in order for it to be reconsidered with the result in your favor.
This class 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 of your appeals, refunds and recoupment
- Learn about how to adhere to the Medicare 60-day rule for overpayments
- Learn how to take a closer look at modifiers, bundling, down coding, and other situations that can cause a claim to be rejected
- Get familiar with researching individual carrier policies for submitting and appealing claims
- Gain access to results-oriented appeal letters
- Effectively respond to inappropriate recoupments and payment inconsistencies, according to state and federal guidelines
Who Should Attend
This class is ideal for billing and claims processors,
physicians, consultants and anyone seeking solutions for claim denials.
The content covered in this course assumes basic to
intermediate knowledge of outpatient billing and carrier reimbursement.
What to Bring
A course manual will be supplied. No supplementary materials
are required for this course. Bring questions and receive guidance for handling
some of your toughest claim denials.
Appeals, Refunds & Recoupment Requests
Not able to attend a live session?
Check out our self-paced version!