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Who should attend Case Management's Role in Managing Third Party Payer Denials Webinar
RN Case Managers, Directors of Case Management, Case Management Senior Leaders, Directors of Finance, Physician Advisors, Director of case management, Case managers, Directors of nursing, Directors of patient flow, Director of revenue cycle, Chief financial officers, Chief operations officers, Chief medical officer, Hospitalists, Director of quality management, Nursing home directors, Director of home care
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Case Management's Role in Managing Third Party Payer Denials Webinar  

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RN Case Managers, Directors of Case Management, Case Management Senior Leaders, Directors of Finance, Physician Advisors, Director of case management, Case managers, Directors of nursing, Directors of patient flow, Director of revenue cycle, Chief financial officers, Chief operations officers, Chief medical officer, Hospitalists, Director of quality management, Nursing home directors, Director of home care

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Seminar Summary:

Case management, as a member of the revenue cycle team, plays a strategic role in the implementation of strategies aimed at reducing and/or preventing third party payer denials. Reducing and preventing denials requires proactive and hard-wired processes that engage the entire interdisciplinary care team. The causes of denials are complex and therefore require complex solutions. This program will review the causes of denials and key strategies for reducing and preventing them. Solutions will include key members of the interdisciplinary care team including physicians, physician advisors, case management leaders and case managers. Strategies for analyzing your denial rate will also be included. (see full course description)

 
 

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Training Course Syllabus:


Objectives of the Presentation

Understand the role of the case manager in providing strategies for reducing denials
Discuss the key roles for preventing denials, including the roles of the interdisciplinary care team
Review key case management strategies for denial prevention and management

Why Should you Attend

Before a department of case management can reduce its denial rate, it first needs to understand what elements within and outside the hospitals are contributing to these denials. Once these root causes have been identified, strategies for correcting them and hard-wiring new practices can be implemented. Reducing denials is an interdisciplinary problem and can only be solved using interdisciplinary solutions.

If your hospital wants to reduce its rate of denials using a strategic approach, this program is for you. Understanding denials in a comprehensive way will positively affect your practice as a case manager or a case management leader.

Areas Covered

Key case management roles impacting denials
Types of clinical reviews
Denial management
Categorizing denials
Key case management strategies for reducing denials
Roles of team members
Definition of revenue cycle
Revenue cycle process steps
Stakeholders
Definitions of medical necessity
Steps in care coordination where denials can occur
Steps in the discharge planning process where denials can occur
Payer expectations
How case management causes denials
How third party payers cause denials

Seminar Summary:

Case management, as a member of the revenue cycle team, plays a strategic role in the implementation of strategies aimed at reducing and/or preventing third party payer denials. Reducing and preventing denials requires proactive and hard-wired processes that engage the entire interdisciplinary care team. The causes of denials are complex and therefore require complex solutions. This program will review the causes of denials and key strategies for reducing and preventing them. Solutions will include key members of the interdisciplinary care team including physicians, physician advisors, case management leaders and case managers. Strategies for analyzing your denial rate will also be included. (see full course description)

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