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