Optimizing Appeals Process: How to Recoup your Denied Payments

Format: On-Demand Webinar
Presenter: Lynn M. Anderanin
Duration: 60 Minutes

Part of the revenue cycle process is the submission of clean claims to the insurance carriers for timely processing and reimbursement. Unfortunately, there are circumstances when insurance companies, whether right or wrong, will deny a claim or claim line. In order to receive the reimbursement expected when a claim has been denied in error, most insurance companies require an appeal be submitted for reconsideration of the denial. It is important that these appeals are thorough and explain in detail why the claim should be reimbursed, and the documentation to support the service or procedure should be also submitted to be reviewed by the insurance company. Even in some circumstances, a second-level appeal will need to be submitted. This webinar will explain common denials and the reason codes which should be used by all insurance companies based on HIPAA guidelines as well as what should be included or excluded in your appeals. We will also discuss easy tips on making your appeals as relevant as possible for easy acceptance by the insurance companies.

LEARNING OBJECTIVES:

• Use denial and remark codes to understand the reason why a claim was denied
• Capture the appropriate documentation to support why the denial is incorrect
• Share with the insurance company what other information is needed for reconsideration
• Create an effective appeal by explaining the circumstances in coding language
• Help the reviewer by sharing as much information as possible for easy acceptance
• Know what forms/formats are needed for a specific insurance company
• Realize the methods of submitting appeals to insurance companies
• Use the 2nd level appeal process when necessary
• Understand what can be done when an appeal denial has been received.

Areas Covered in the Session:

• Finding and understanding denial and remark codes
• Common denials and how they will need to be reconciled
• NCCI policies that create denials
• Understanding each insurance company’s appeals process
• The appeals process
• Writing an effective appeal
• What should be documentation should be submitted
• Knowing what to do when an appeal is not enough

Suggested Attendees:

• Billers
• Coders
• Claims Adjusters
• Claims processors
• physicians
• Nurses
• Physicians Assistants
• Scribes
• Managers
• Administrator
• Insurance collectors

Other Related Webinars:

• 2022 Updates for ICD-10-CM

About the Presenter:

Lynn M. Anderanin, CPC, CPB, CPMA, CPC-I, CPPM, COSC is the Sr. Coding Educator for Healthcare Information Services, a revenue cycle management and consulting service in the Chicagoland area. Prior to relocating to Chicago, Lynn was the Billing Office Manager and surgical coder for Hand Surgery Associates, now Michigan Surgery Specialists in the Detroit Area.  She has over 39 years of experience in all areas of the physician practice including Practice Administrator, Billing Manager, and Director of Operations.  Her experience is primarily in the specialties of Orthopaedics, Rheumatology, and Hematology/Oncology. She has been a speaker for many conferences, including the AAPC National Conferences and Workshops, Community Colleges, Audio Conferences, Certification classes, and Webinars.  Lynn became a CPC in 1993, a Certified Instructor in 2002, a Certified Orthopedic Surgery Coder in 2009, an examination in which she participated in creating. She passed the Certified Practice Manager exam in 2015, the Certified Medical Auditor exam in 2016, and the Certified Professional Biller exam in 2021. Lynn is the founder of the first local chapter of the AAPC in Chicago, which is now 25 years old, and a former member of the AAPC National Advisory Board as well as several other committees for the AAPC.

After Registration: You will receive an email with login information and handouts (presentation slides) that you can print and share with all participants at your location.

System Requirement Operating System: Windows any version preferably above Windows Vista & Mac any version above OS X 10.6

Internet Speed: Preferably above 1 MBPS

Headset: Any decent headset and microphone which can be used to talk and hear clearly

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For more information you can reach out to the below contact: Toll-Free No: 1-302-444-0162 Email: support@skillacquireupdate.com