Successful Appeal Strategies for Federal Payor Claims
It’s a lot easier for your practice to win appeals and receive compensation. The CMS has made the Medicare Appeal process simple and faster by clearing its backlog. in the case of Medicare, and will immediately begin to process new claims. With a few easy changes to your appeal process, you can recover the substantial amount of reimbursement. The money’s yours, and you need to know how to take care of it. Changes to your appeal argument, regulatory support, and knowledge of how to interpret the decision on appeal can lead to lucrative results in a number of circumstances.
This course will outline how to appeal denied claims from federal payors more effectively and efficiently. Understanding the different levels of appeals, the development of a strategy for each case, and writing persuasive appeal letters. You will also master the nuances of submitting appeals, such as reopening, network status, and clinical and coding reviews. By the end of this course, you will improve your appeal process and have the tools to recover more revenue, by ensuring success by understanding that details matter when it comes to keeping your money.
Learning Objectives
Understand the various levels of appeals within Medicare FFS, Medicare Advantage and Medicaid plans
Develop an appeal strategy to submit appeals timely and with favorable outcomes
Learn best practices based on contractor types for submission, tracking, and determinations
Know All the Medicare and Medicaid Appeal Nuances
Understand In-Network and Out-of-Network Claims
Master Precertification (or Prior Authorization) Appeals Tactics that Get Your Claims Approved
Areas Covered in the Session
Hold payors accountable to their response deadlines
Write a winning appeal argument and get more denials overturned
Streamline your appeal content and don’t submit too much information
Master Medicare and Medicaid appeal nuances
Find out how to use appeal reopenings to collect even more revenue
Cut through the confusion between appeals for in- and out-of-network claims
Improve your appeals process with Payer-Specific strategies
Demand clinical and coding reviews to overturn more
Live Q&A Session
Suggested Attendees
Healthcare CEOs
Healthcare CFOs
Healthcare COOs
C-level Executives
Office Staff and Billing Managers
Medical Billing Companies
Hospital Revenue Cycle Staff
Physician
Nurses
Physician Assistants
Nurse Practitioners
Medical Assistants
Practice Manager
Office Managers
Billers
Coders
Auditors
CDI Specialists
Collection Staff
Front Desk
Compliance Officers
Telemedicine System Vendors
Patient Accounts Personnel
Medical Record Supervisors
Other Personnel Interested in Billing and Appeal
Health Information Management Administrators and Technicians
Medical Providers, Who are Involved in the Payment Process of their Practice
About the Presenter
Kelly Grahovac serves as the General Manager for The van Halem Group where she focuses on audits, compliance, education, and resolving complex issues for clients in the post-acute care space. Kelly has over 20 years of experience working at one of the nation’s leading Medicare contractors and with The van Halem Group and is a known lecturer in the HH&H and HME industry, speaking at national conferences, state associations, and for private events. In addition, Kelly is a common contributor to a variety of industry publications and serves as a board member for both the South Carolina Medical Equipment Suppliers Association (SCMESA) and Big Sky Association for Medical Equipment Suppliers (AMES). Kelly also serves on the National Supplier Clearinghouse Advisory Committee (NSCAC).
Additional Information
System Requirement:
Internet Speed: Preferably above 1 MBPS
Headset: Any decent headset and microphone which can be used to hear clearly
Live Course Cancellation Policy: If for any reason Skillacquire need to cancel this program, Skillacquire will notify participants by email of the cancellation no less than 24 hours prior to the expected start time.
For more information, you can reach out to the below contact:
Toll-Free No: 1-302-444-0162
Email: care@skillacquire.com