Complementary Appeal Instruction and Strategies presented twice a month by AppealMasters expert staff and special guests throughout the Summer
First Webinar: Thursday, July 6, 1:00 PM – 2:30 PM EST
Where: Online via WebEx • Duration: 1 hour
What you will learn this summer
Commercial denials and overpayment audits are an ever-continuing threat to a healthy revenue cycle and take directly from your bottom line. Hospitals and health systems are treading water with the onslaught of payer challenges to legitimate and necessary care for your communities. Without a well-informed tactical response and appeal escalation strategy, your rightfully earned revenue is withheld, recouped and otherwise seriously at risk. Overpayment Auditors and commercial payer UM departments are going to the bank with faxed correspondences, denying correctly obtained authorizations and medically necessary admissions.
Join us this summer in working out strong, viable arguments and streamlined appeal strategies that will get every payer’s strict attention.
Session One: Dealing with Payer/Auditor Misinformation, “Fuzzy” Contract Abuse and Payer Non-Compliance
Payers are using misinformation and “fuzzy” contract abuse in both payer and auditor correspondences, leaving even the most experienced business office and appeal experts struggling to understand why the procedure or stay (or a portion) was denied, when the appeal is due, and exactly where and to whom it should be sent.
Payers are ignoring your hospital’s statutory and regulatory protections under EMTALA, ERISA and the Code of Federal Regulations (Title 42, Part 438), mainly because providers AREN’T CALLING THEM ON IT! This payer “malfeasance” runs across all denial categories, technical, clinical and behavioral.
Listen and learn how to win more appeals and protect your revenue by strengthening your appeal processes, improve payer oversight and standing up for your provider/beneficiary rights.