Medicare Appeals: Overturn RAC Denials Using the Medicare Appeal Process
Product Description:
AUDIO CONFERENCE ON CD OR AUDIO ON-DEMAND
Sponsored by: 
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presented on July 21, 2009
PROBLEM
Appealing a denied claim to Medicare has always had its challenges, but with the Recovery Audit Contractors (RAC) permanent program rolling out, more of your revenue is likely to come under scrutiny. And that means you need to do more to hold on to your reimbursements. Hospitals need to react to denied claims in a timely manner with the right documentation. Is your facility in the best position to fight a denied Medicare claim?
SOLUTION
A fundamental understanding of the appeal process-and how RACs will cause this process to change-can make an enormous difference in the successful fight against overturned claims, as well as help you establish policies and procedures to help prevent denials in the first place. Knowing how to manage the time frame for appealing denials, as well as how to track submitted appeals are effective strategies for holding on to the reimbursement you deserve.
LEARN FROM US
HCPro presents a 90-minute audio conference, Medicare Appeals: Overturn RAC Denials Using the Medicare Appeal Process featuring speakers Stacey Levitt, RN, MSN, CPC (Lenox Hill Hospital), and Tanja Twist, MBA/HCM (Methodist Hospital of Southern California). The speakers provide valuable tools and references you can use at your facility to help negate a Medicare claim denial. Collateral such as flowcharts, templated appeals letters, and data mining techniques will provide a step-by-step outline of how to efficiently appeal a denied claim, while keeping an eye on what changes to the RAC appeals process you can expect now that RAC has unveiled its permanent program.
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HCPro, Inc. has determined this program meets one or more of the following criteria:
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LEARNING OBJECTIVES
At the conclusion of this audio conference, you will be able to:
- Identify the steps needed for each level of appeal
- Understand the difference between the demonstration and the permanent RAC project with respect to appeals
- Learn time-tested techniques for successful appeals
- Determine what time frames exist for appeals
AGENDA:
- Timelines for handling claim denials and appeals
- RAC appeals vs other Medicare appeals
- Types of Medicare (including RAC) denials
- Technical denials
- Medical necessity denials
- Coding denials
- Claim appeal tracking methods
- Techniques to help ensure successful appeals
- Operationalizing the appeals process
- Ensuring appropriate documentation
- Strategies for use at the Administrative Law Judge level
- Question and answer session
BONUS TOOLS
In addition to the expertise and advice presented during this audio conference, you'll also receive a slide presentation of the program materials and:
- Medicare appeal time frame
- Sample letter for appeals that you can customize
- RAC tracking tools
- Template letters
MEET THE SPEAKERS
Stacey Levitt, RN, MSN, CPC, director, patient care management, Lenox Hill Hospital (New York City, NY). Levitt has a solid clinical nursing background in both critical care and public health. Her ongoing administrative experience includes more than 20 years in healthcare management settings. Her areas of expertise include utilization and denial management, reimbursement analysis, performance improvement, professional staff development, and project management. Levitt's expertise includes data management and analysis relating to hospital and physician reimbursement.
Tanja Twist, MBA/HCM, director, patient financial services, Methodist Hospital of Southern California (Arcadia, CA). Twist is responsible for oversight of the admitting and business offices at her 460-bed nonprofit facility. She has more than 20 years experience in healthcare management, and is the current national finance chair for the American Association of Healthcare Administrative Management (AAHAM).
WHO SHOULD LISTEN?
Professionals employed by hospitals that provide Medicare part A services, including: revenue cycle manager/director, patient financial service director, compliance officer, HIM director, coding manager, biller, denial manager, case manager, finance department staff, and patient accounts/patient access staff.
AUDIO ON-DEMAND
In addition to the regular participation options for HCPro audio conferences—live, CD, or combination packages—we are pleased to offer another option, audio on-demand. Audio on-demand allows you to download the program and play it back at your convenience through your computer or MP3 player. Purchase a CD or audio on-demand of the program and listen when you can. It's also a perfect training tool for new staff or as a refresher for veteran staff.
About our sponsor |
The Revenue Cycle Institute is your go-to source for services and tools to achieve revenue integrity. Expert consultants and eduators provide audits, assessments, operational reviews, and customized training programs. Visit the Web site for white papers and news updates on revenue cycle challenges including:
Consulting, auditing, and onsite education customized to your organization's unique needs. Visit us online or call 877/233-8734. |
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