Understand how to overcome the challenges of medical necessity denials to avoid lost time and money.
Health care providers face daunting challenges in addressing increasing volumes of medical necessity denials from third party payers. Medical necessity denials are extremely costly requiring rework, investigation, and appeal, not to mention the time value of money and lost opportunities to put the monies to work in the hospital. These types of denials are pervasive, difficult to successfully challenge and result in a low recovery rate. Due to often-times low dismal recovery rates and high volume of denials, there is a strong tendency to view these denials as the cost of doing business that is simply factored into the revenue cycle.
An effective approach to managing third party payer denials is to invest in the resources, education of all relevant health care stakeholders, technology, and processes to mitigate and avoid denials in the first place. There are countless contributing factors to medical necessity denials beyond the reporting of a 'non-covered' diagnosis. During this topic you will learn best practice principles and practices in the revenue cycle to minimize medical necessity denials beginning with efforts to progressively transform inefficient repetitive denials management into a cross cultural environment embracing concepts and thought processes of denials avoidance.
Agenda
Faculty
Glenn Krauss, VBBA, RHIA, CCS, CCS-P, CPUR, CCDS, C-CD
Glenn Krauss, VBBA, RHIA, CCS, CCS-P, CPUR, CCDS, C-CDI, C-DAM, C-P
- Founder of Core-CDI.com
- Experience includes over years of progressive practical hands-on experience in clinical coding & documentation improvement, subscribing to the philosophy that quality of medical record documentation strongly correlates with overall quality of care & the overall achievement of a high performing revenue cycle
- Well-recognized and respected subject matter expert in the revenue cycle with an emphasis & focus upon collaborating & working closely with physicians in promoting, advocating for, educating & achieving sustainable improvement in clinical documentation that accurately reflects & reports the communication of fully informed coordinated patient care
- Experience in implementing various electronic health records including Cerner, Meditech, Athena, and Epic
- Has been instrumental in helping client physicians develop documentation templates to help streamline the EHR charting process as well as developed model documentation policies governing the Copy & Paste functionality within the EHR. Glenn works with Information Technology departments within hospitals and medical centers to develop extensive EHR training modules for physicians to take and become proficient in utilizing the EHR, navigating and controlling the documentation within the EHR versus the EHR controlling the documentation
- Frequently presents to many hospital associations, AHIMA and ACDIS chapters, and the American College of Physician Advisors
- Member of AHIMA, ACDIS, and HFMA
- B.B.A. Degree in management, Hofstra University in Hempstead, New York
- Can be contacted at 603-303-3337 or [email protected]
All of your training, right here at Lorman.
Pay once and get a full year of unlimited training in any format, any time!
- Live Webinars
- OnDemand Webinars
- MP3 Downloads
- Course Manuals
- Audio Recordings*
- Executive Reports
- White Papers and Articles
- Sponsored Live Webinars
Additional benefits include:
- State Specific Credit Tracker
- Members Only Newsletter
- All-Access Pass Course Concierge
* For audio recordings you only pay shipping
Questions? Call 877-296-2169 to speak with a real person.
More Program Information
Access to all training products $699/year
Unlimited Lorman Training
With the All-Access Pass there is no guessing what you will need for your yearly training budget. $699 will cover all of your training needs for an entire year!
Easy Registrations
Once you purchase your All-Access Pass you will never be any further than one-click away from attending any Lorman training course.
Invest in Yourself
You haven't gotten to where you are professionally by luck alone; it's taken a lot of hard work and training. Invest in yourself with the All-Access Pass.
