Denials and Audits: Strengthen Your Prevention and Appeals Management

Are your denial prevention and audit management efforts stuck in neutral — or even going in reverse? Many hospitals and other providers have tried to improve their ability to capture and retain crucial revenue. Payers have responded by doubling down on prepayment and retrospective audits, resulting in changes to submitted patient statuses and diagnoses. Adding insult to injury, this is typically followed by indiscriminate delays in deciding provider appeals. How do you avoid this narrative and protect your revenues from denials and recoupments?

Although the odds may not seem to be in your favor, you can build an effective program to manage denials, audits and appeals. From this exclusive RACmonitor webcast, you’ll learn about essential strategies for building your program, starting with winning buy-in and support from stakeholders across your organization. Through this approach, coupled with better systems management, stronger oversight and improved process engineering, you’ll gain an advantage in your quest to prevent denials and audit-proof your payments.

Why This Is Relevant:

Payer denials and audit takebacks continue to accelerate at an alarming rate, eroding already-thin margins. Will you fight back or allow yourself to be bullied? The trio of denial and appeals management experts we’ve brought in for this RACmonitor webcast will guide you through proven concepts for approaching denials and audits in a measured and systematic way.

Learning Objectives:

• Strengthen your ability to build a multidisciplinary denial, audit and appeals management program
• Learn how to break down the “denial silos” across your organization
• Understand the definition of “root cause” as it pertains to healthcare insurance denials
• Identify the key performance metrics and measures necessary for tracking payer denials and audits
• Take away five quick steps to prevent denials and recoupments

Who Should Attend:

Revenue cycle leaders, physician advisors, chief financial officer, managed care director, utilization management/review leaders, revenue integrity leaders and HIM director/manager.