The Appeals Process – Optimizing Compliant Revenue

HEALTHCARE Apr 20, 2018 60 minutes
01:00 PM EST 12:00 PM CST 11:00 AM MST 10:00 AM PST

Description:-

Third-party payers continue to make collecting for services more and more challenging. And the fee schedules continue to be reduced. As the reimbursement per service falls and improper denials continue to arrive at the practice, it is critical that the billing and coding operations implement an assertive appeals process, holding third-party payers accountable for paying for services rendered, documented, appropriately coded and billed.This is a tedious process and cannot be overlooked because it may be the difference between profitability and the loss of a practice.

Why Should You Attend? 

  • Whose responsibility is it anyway?
  • How to identify claims that need to be appealed
  • The difference between an appeal and the re-processing of a claim
  • Where do your appeal opportunities lie
  • What tools do you need in the office to assist with appeals?
  • What should be included in an appeal
  • What must be communicated to the payer in the appeal?
  • What is the Formal Medicare Appeal’s Process?
  • How do private payers’ appeals processes differ from Medicare’s appeals process?

Who will benefit?

  • Providers
  • Administrators
  • Billing Managers
  • Coders
  • Billers
Presenter BIO

Barbara J. Cobuzzi: is owned CRN Healthcare Solutions where provides value-added provider consulting services. She holds a BS in Industrial Engineering from Rensselaer Polytechnic Institute and an MBA from New York University. She holds certifications from the AAPC as a CPC (certified physician coder), COC (certified hospital outpatient coder), CPC-P (certified payer coder) a CPC-I (certified coding instructor) and a CPCO (certified professional compliance officer). She also holds a specialty certification in Otolaryngology (CENTC). Ms. Cobuzzi is a past member of the AAPC National Advisory Board as well as their Executive Board. Ms. Cobuzzi owned Cash Flow Solutions, a medical billing company for 13 years where practices received high value-added coding and billing services before she closed the billing company and entered full time consulting. Barbara provides litigation support as an expert witness for providers and payer. Barbara is a speaker for many local and national organizations. Barbara Cobuzzi is also the Consulting Editor of Otolaryngology Coding Alert.

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