Payer denials continue to strain revenue cycle teams, often because appeals rely solely on clinical arguments while overlooking powerful contractual, legal, and regulatory protections. This webinar explores how a combined clinical and legal approach can significantly improve overturn rates, strengthen payer accountability, and drive measurable financial results.
Attendees will learn how to leverage contract language, regulatory requirements, and legal arguments to enforce payer “Rules of Engagement” and reduce unnecessary friction in the appeals process. We’ll examine when and how to incorporate legal reasoning into clinical appeals, identify the financial risks of limited visibility, and demonstrate how a more disciplined, informed strategy can improve operational efficiency and protect the bottom line.
Designed for revenue cycle and appeals leaders, this session provides practical guidance to help teams move beyond reactive denial management and toward a more assertive, results-driven appeals strategy.
Attendees will:
-Gain a better understanding of the purpose of including legal arguments in clinical appeals.
-Learn how to apply their contractual, legal and regulatory protections that can improve operational efficiency
-Learn how to enforce payer compliance with the Rules of Engagement
-Be able to identify the types of legal arguments that could be included in clinical appeals.
-Learn how to apply the correct legal arguments with the appropriate circumstances for use.
-Become familiar with the financial risks and dollar impact that “zero visibility” creates
Presenters: Brian McGraw, Chief Executive Officer | PayerWatch
Craig DeFrancisco, General Counsel & Corporate Compliance Officer | PayerWatch
