Wednesday, July 31st, 2019 2:00 pm
Don’t miss this excellent educational opportunity designed to better equip you for successfully appealing denials with the use of evidence based medicine and standards of care!
Hosted by: Denise Wilson MS,RN,RRT
Vice President, Clinical Appeal Services
Hospital readmissions for related conditions remains a huge target for audits and denials. We’ll discuss common reasons for denials of hospital readmissions and how to respond using clinical criteria and common sense. Join us as we share what we’ve learned over the years from appealing hundreds of readmission denials on behalf of our hospital clients. We’ll reveal payer behaviors regarding auditing and denying readmissions. We’ll discuss the relevance of clinically related and potentially preventable as well as readmission denial exclusions. As always, we will share proven, successful appeal strategies that you can use right away.
- Define a patient readmission and the payer penalties associated with inappropriate readmissions.
- List the common reasons why payers audit and deny for patient readmissions.
- Describe methods of defending appropriate readmissions through the appeals process.