What is a medical denial?
A medical denial is an adverse payor determination for any type of health benefits coverage or reimbursement. It may be for the preauthorization of a product or service or a denial of a claim for reimbursement for the product or service provided. Applies to any type of payor and payor program and may be the end result of an investigation, audit or recoupment action. This video reviews when the appeals rights are triggered and discusses how a denied party should approach a denial.
Agenda
Faculty
Patrick D. Souter
Gray Reed & McGraw LLP
- Of Counsel, Gray Reed & McGraw LLP
- Representation of physicians, hospitals and ancillary providers in operational, regulatory and administrative matters
- Board Certified in Healthcare Law by the Texas Board of Legal Specialization
- Adjunct Professor of Healthcare Studies at Baylor University School of Law and the Baylor University Hankamer School of Business’ Robbins Institute for Health Policy and Leadership
- Frequent speaker to national and local healthcare organizations on physician, hospital and other provider issues
- Recognized as a leading healthcare lawyer in Texas by Chambers & Partners USA (2020 - 2023) and selected by his peers for inclusion in Woodward/White, Inc.’s The Best Lawyers in America in the field of Health Care Law (2019 - 2023)
- Frequent author of books and articles on various topics
- LLM degree in Health Law from Hofstra University; JD degree from Baylor University School of Law, MBA degree, Health Services Management from the University of Dallas, BBA degree, in Finance from Baylor University Hankamer School of Business
- Can be contacted at [email protected] or (214) 954-4135
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