Denials Management: Optimizing your Claim Denial Management Process
Claim denials are an important part of the revenue cycle and a reason for low reimbursements. Too often processing denials is put on the back burner to charge processing and payment posting. This webinar is going to look at the most common denials and give attendees valuable information on how to better manage denials so that reimbursement is not left on the table. We will discuss methods of creating a process to ensure that timely filing limits are met and learn how tracking denials can assist in understanding changes in insurance carrier policies.
The first step of denials management is understanding the transaction codes sets that are used by insurance companies to deny claims and confirm that a denial is valid. Once a denial is found to be incorrect, it has to be appealed to show the denial was incorrect. This process can be set up to be streamlined to save time and resources. Organizing the process allows multiple staff to be involved so that staff strengths are used. This process will also assist in identifying trends when insurance companies have changed their policies or coding and billing staff are unaware that errors are being made.
We will review the denial and remark codes of the most common denials and where these can be found as well as common claims edits that also code denials. We will walk through setting up a proven denials management process that includes recognizing trends in denials that can assist in seeing policy or coding changes that need to be implemented. When the denial is incorrect it is important to write an effective appeal for reimbursement and real examples will be shared
- Finding and understanding denial and remark codes
- Common denials and how they will need to be reconciled
- NCCI policies that create denials
- Creating a denials management process-based staff and technology
- Trending denials using your practice management system
- The appeals process
- Writing an effective appeal
- Knowing what to do when an appeal is not enough
Who Should Attend
Reimbursement team, collectors, biller, coder, revenue cycle manager, administrator, cash poster, claims adjuster, claims manager.
Lynn M. Anderanin
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