An Average of 18% of All Claims Were Denied in 2006!
Claim denials by managed care organizations continue to plague healthcare providers, according to a new survey by the Managed Care Information Center. It’s one of the leading problems confronting both hospitals and physicians.
Ineffective claim processing systems, system interface issues, eligibility issues, medical necessity, poor quality control, insufficient contract language, lack of training, and coding errors are among the myriad reasons for the high rate of payor denials.
But experts believe as much as 90 percent of claim denials may be preventable!
Learn how to prevent claim denials before they happen to obtain the revenue your organization is entitled to!
Join Healthcare Reimbursement Monitor and three reimbursement experts to find out how to submit approvable claims in "Denials Prevention: Management Strategies, Best Practices, and Procedures to Optimize Reimbursement and Improve Cash Flow," a 90-minute audio conference that took place in September 2007.
Presenters
Linda Fotheringill
Principal,
Washington & West, LLC
Karen Moore
Manager of Patient Accounts,
Shore Health System
(Easton, MD)
Pam Waymack, FHFMA
Managing Director,
Phoenix Services Managed Care Consulting, Ltd.
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Agenda
- Today's Broader Definition of Denials
- Why Denials "Prevention" Instead of "Management"
- "Silent Denials" -- Identifying All Areas of Potential Reimbursement Optimization
- What Are Your Missed Opportunities to Increase Cash Flow?
- Leveraging Your Denial Database to Optimize Initial Reimbursement
- How Your Payor Contracts are Costing You Money
- How to Develop Fair Third Party Agreements to Avoid Denials
- Strategies for Covering the Uninsured
- Using Denials Prevention to Control Your Budget
- How to Hold the Payor to Agreed Upon Terms
- Case Study: How Shore Health System Reduced Their Denials Dramatically Through Prevention Tactics
- Developing a Formal System to Better Understand Denials and Facilitate Prevention
- Lessons Learned by Shore Health System
- Question and Answer Session
Who Should Attend This Conference
CEOs, COOs, CFOs, vice president of finance, director of reimbursement, vice president of operations, strategic and implementation consultants, operations executives, executive directors, team leaders, planners, product managers, knowledge managers, department heads, medical directors, director of managed care, director of contracting, network development and provider services directors, strategic planners, healthcare management, TPAs, network managers, physician practice management, company executives, medical management directors, PHO and IPA leadership, analysts, implementer consultants, account services and administration executives.
