Preventing Denials. Winning Appeals.
Denials and audit takebacks continue to increase at an alarming pace. Protect and defend your hard‐earned revenue with PayerWatch’s advanced Veracity platform and AppealMasters denial | audit | appeal experts.
AHDAM Virtual Winter Workshops!
We are thrilled to announce AHDAM Virtual Winter Workshops. Spanning late January and early February 2024, these interactive sessions are designed to be informative and educational sessions led by field experts who will dive deep into crucial topics that are vital to understand the complex and ever-changing nature of the denial and appeal management process.
Please join us for the following workshop tracks:
Clinical Validation Denials and Appeals (January 23rd and 24th)
Join us as Karla Hiravi and Christi Drum dive into the importance of understanding clinical validation as it relates to denials and appeals. This workshop presents a unique opportunity to enrich your understanding of the clinical validation process in today’s ever evolving denials and appeals landscape.
Medical Necessity (January 25th and 26th)
Join Denise Wilson and Dr. James Cartwright for our Medical Necessity workshop. This session offers indispensable insights into successfully appealing medical necessity, level of care, and patient status denials from commercial and government payers.
Coding Denials and Appeals (January 30th and 31st)
Dive into the intricacies of coding denials and appeals with Christi Drum, Deb Smith, Karla Hiravi, and Michelle Sartelle. Enhance your ability to navigate complex coding denials and learn practical strategies to overcome common coding denial challenges.
Revenue Cycle (February 1st and 2nd)
Unravel the Revenue Cycle with insights from Brian McGraw and Dr. Kendall Smith. The Revenue Cycle workshop is designed to help healthcare professionals manage and optimize the financial processes that drive their organizations.
Join us for these powerful learning experiences, and step into 2024 equipped with the knowledge and skills to elevate your institution’s healthcare management. Do not miss out – mark your calendars now.
Registration for the workshops will open on November 15th, 2023. More information will be provided shortly. We look forward to seeing you in 2024!
Presenters:
Denise Wilson, MS, RN, RRT
James Cartwright, MD
Karla Hiravi, BSN, RN
Christi Drum, BSN, RN, CCDS, CCS
Deb Smith, CCS
Michelle Sartelle, RHIA, CCS, CPC-A, RRT
Kendall Smith, MD
Brian McGraw
PayerWatch is the nation’s leading clinical revenue cycle and process improvement solution.
Is your hospital or health system equipped with the strongest tools and denial expert partners to effectively defend yourselves from payer denials and audits? PayerWatch is proven in over 500 hospitals nationwide.
Veracity
Revenue Protection Engine
Denials | Audits | Appeals
Dramatically increase your revenue protection and plug the payer leaks with our Veracity enterprise platform. Guaranteed.
- Denial prevention now
- Rapidly identify and fix broken processes
- Recover more revenue faster with fewer steps
- Clinical Validation Challenges
- Medical Necessity Denials
- Clinical/Legal Unit Approach
- Supporting 500+ Hospitals
PayerWatch Appeal Support Services
Supplement your internal resources with PayerWatch’s AppealMasters team of revenue recovery experts and complex payer appeal services. We’ll continuously train, educate and transfer knowledge as we help you win more appeals faster. Because performance improvement matters.
Advocacy, Training and Support
The Association of Healthcare Denial and Appeal Management (AHDAM) provides ongoing training and resources for all health care providers nationwide. AHDAM offers extensive training and education in denial and appeal management. Led by an expert team of denial and appeal management physicians, nurses, coders and attorneys.
PayerWatch is a fierce advocate for healthcare providers.
We empower you with the most efficient and effective tools to manage abusive payer practices, payer denials, payer audits and a winning appeal process.
Whether you’re leveraging the technological advancements of our Veracity revenue protection engine or supporting your internal teams with our expert AppealMasters support, PayerWatch is your trusted partner for revenue protection and defense. Over 500 hospital clients feel the same.
Preventing Denials to Increase Revenue
Veracity will not only help you get paid sooner and more often, but our solutions also drastically reduce the hard and soft costs associated with the administrative burden of audits and denials.
Enterprise Revenue Risk Management
Payer denials and audit takebacks are the unspoken black plague in Healthcare Revenue Cycle Management. Clinical denials, external audits, and the resulting lost revenue have been a blight on providers for too many years. PayerWatch’s Veracity platform presents a centralized platform for revenue risks across the enterprise – hospital, clinic, and ancillary denial and audit challenges that centralizes your responses, tracking, and healing your revenue at risk.
Finally – a flexible workflow engine for quickly fixing broken processes
Despite the attention and efforts that providers have dedicated towards denial prevention and audit management, improvements in re-capturing or retaining this crucial revenue remain difficult to achieve. PayerWatch’s Veracity platform identifies and fixes broken or inefficient revenue cycle processes quickly and effectively across all involved departments. Get it done today, not three months from today.
AppealMasters – Your lean and mean denial fighting machine
AppealMasters is the dedicated PayerWatch team of specialized clinical-legal appeal experts who serve providers by responding to all government and commercial payer denials and audits. Our professionals offer as-needed services and support from initial denial to ALJ hearings and External Review. Training, education, and process improvement recommendations are all included in our appeal support partnership.
Preventing Denials. Winning Appeals.
With AppealMasters, your organization benefits from winning appeal letters that include evidence-based medicine, NCD/LCD guidelines and state-specific legal arguments to support the appeal and reference specific findings in the medical record. Over 300 hospitals trust our expertise to appeal payer denials and audits through a comprehensive set of tools and services. Detailed reporting, corrective action recommendations, and collaborative insights are all part of being a dedicated team player with your staff.
Webinar: Successfully Defending Outpatient Authorization Denials
Wednesday, October 18, 2023
2 PM Eastern Time
Successfully Defending Outpatient Authorization Denials
Wednesday, October 18, 2023 | 2:00 PM to 3:00 PM (ET)
Summary: Obtaining preauthorization for outpatient services is vitally important in avoiding denials. But, even when preauthorization is obtained, denials can still occur. Denial and appeal management professionals must become experts in navigating the sea of outpatient preauthorization processes, denials, and appeals. Join us as experts in the field discuss ways to prevent authorization denials, how to hold payers accountable for delayed decisions, and strategies to defend outpatient authorization denials.
At the conclusion of the webinar, the learner will be able to:
Self-report they can identify one way to help prevent outpatient authorization denials, one way to hold payers accountable for delayed decisions, and a successful strategy to employ when appealing outpatient authorization denials.
At conclusion of the webinar, at least 90% of participants will share on the evaluation:
- The ability to identify one way to help prevent outpatient authorization denials
- Identification of one way to hold a payer accountable for delayed decisions
- Identification of a successful strategy to appeal outpatient authorization denials
Presenters
Denise Wilson MS, RN, RRT
President | Association for Healthcare Denial and Appeal Management
Senior Vice President | PayerWatch – AppealMasters
Reggie Allen, MBA, RN, ACM
Chief, Clinical/Business Operations | PayerWatch + AppealMasters
PayerWatch AppealMasters Experts are Passionate About Making the Payers Pay
Our industry‐leading customer service is available to help and support everything you need to succeed in this incredibly challenging payer-provider environment. The PayerWatch staff are experts in medical necessity, clinical validation/CDI, coding, contracts, and legal protections who deeply understand the issues at hand and can help solve your denial, audit, and payer challenges. You get a serious, educated collaborative, and expert partner. Our Veracity and AppealMasters teams build close working relationships with your staff, who share in the service mission to improve processes and payment outcomes together.
Trusted Partners
PayerWatch has increased revenue for over 500 hospitals.
PayerWatch's industry-leading Veracity software and AppealMasters’ infrastructure is HITRUST CSF Certified.