Helping healthcare providers protect their revenue from payer denials and audits.

With our proven combination of appeal services, consulting and denial management technology, clients successfully:

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Manage and prevent payer denials

Accelerate denied claims appeals

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Conquer payer audits

Successfully Appealing 
Clinical Validation Denials

Wednesday, October 23rd 2019 at 2 p.m. (EST)

Hosted by: Denise Wilson MS,RN,RRT
Vice President, Clinical Appeal Services

Summary:

Clinical validation denials are still the hottest topic out there in the denial and appeal management world. AppealMasters began successfully appealing clinical validation denials almost a decade ago when Medicare’s Recovery Audit Contractors were the most voracious auditors out there.

Over the past several years the Commercial payers have ramped up their clinical validation audit efforts to levels never before seen. Successfully appealing these denials comes down to understanding the core issues behind the denials and implementing a few key appeal strategies. You can be successful in your appeals as well.
 
Join us as we share what we’ve learned over the years from appealing hundreds of clinical validation denials. We’ll reveal payer behaviors regarding auditing and denying diagnosis codes. And, as always, we will share proven, successful appeal strategies that you can use right away.

  • List common clinical validation denial rationale.
  • Recognize the core issues in clinical validation denials.
  • Describe successful strategies to compose winning appeals when the payer denies the diagnosis, even though you got it right.
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