Get Paid What You’re Owed: Build a Denial Management Program

Capturing the full reimbursement for patient care becomes more elusive with each passing day. Not only are payment denials growing in volume, but payers are finding new, more creative ways to hold onto their money. On top of that, rules and regulations can vary from one payer to the next. And even if your claim is approved for payment today, it might be rejected tomorrow, based on ever-changing clinical criteria and policies.

Don’t settle for less than what you’re owed. From this exclusive ICD10monitor webcast, you’ll learn from Robin Sewell how to start building a successful denial management program. Robin will walk you through crucial program elements, from assembling key players, to establishing governance, to assembling a clinical and coding reference library of appeal templates, audit checklists, tip cards and “cheat sheets.” She’ll also provide practical guidance with organizing a data collection workflow, designing dashboards that deliver meaningful insights and developing key performance indicators (KPIs).

Why This is Relevant:

Hospital claim denial rates are at an all-time high, according to a recent RevCycle Intelligence article.* This distressing trend translates to substantial revenue losses — coming at a time when providers are still struggling to regain their financial health. One of Robin Sewell’s core areas of focus is helping hospitals capture and keep every dollar of revenue that’s rightfully theirs. You’ll definitely want to tap into her expertise in the design and implementation of a strong denial management program.

Learning Objectives:

• Learn about the importance of clinical and coding reference libraries
• Identify productive KPIs for managing denials
• Be able to create dashboards for denial insights
• Understand denial types, including clinical validation, coding, readmissions, short stays and medical necessity, so you’re able to formulate a library of appeal templates
• Learn how to develop appeal strategies through audit checklists and tip cards

Who Should Attend:

Clinical documentation integrity (CDI) professionals, coders, utilization review/management staff, physician advisors and revenue cycle leaders.