Summary:
In recognition of Sepsis Awareness Month, PayerWatch and AHDAM join together to present three Sepsis Denial/Appeal workshops. Sepsis is the leading cause of death in U.S. hospitals, and the lack of definition/treatment consensus between providers and commercial insurers is infuriating and dangerous. Join an expert faculty of Physician Leaders from Adventist Health, UNC Hospitals, Sound Physician Advisory, as well as CDI Nurses and Coders, and let’s challenge the #1 Payer Denial plaguing hospitals across the U.S. One complimentary registration will ensure you receive access to all three workshops. Please support the Sepsis Alliance and learn more at sepsis.org
9/15 – Sepsis Denial/Appeal Workshop 1 – Sepsis 2 vs. Sepsis 3 and How To Write a Successful Sepsis Appeal (Dr. Ossman, Dr. Smith, Denise Wilson) This webinar will cover the ongoing dichotomy of using Sepsis 2 or Sepsis 3 to clinically support a sepsis diagnosis and how to successfully appeal when the provider and payer are using differing definitions.
Presenters:
Paul Ossman, MD, MPH
Dr. Ossman a practicing academic hospitalist at UNC Chapel Hill Medical Center. Ossman has been involved with UNC since medical school in 2001 where he received his MD, MPH, and completed residency. Currently he serves as the Lead Physician Advisor for Clinical Documentation Integrity for the Medical Center. As the Lead PA, Dr. Ossman focuses on DRG optimization, insurance denials, and the role CDI plays in expected mortality reporting. His work has been recognized with a Quality & Safety Award in Special Recognition for Institutional Spread and Sustainability in Recognition of the Project Mortality Reduction Program.
Kendall Smith, MD
Dr. Kendall Smith is a Senior Fellow in Hospital Medicine (SFHM) and currently acts as Chief Physician Advisor for AppealMasters, a leading appeal educator and appeal services firm for hospitals and health systems. He’s been deeply involved in denial and appeals management throughout his hospitalist career, working collaboratively with UR/Case Management departments as well as Managed Care and Hospital C-Suite executives.
His familiarity with managed care denials led him to design and implement a number of CDI programs, including those at the Cleveland Clinic in Florida and the MedStar Washington Hospital Center. He has served as a physician leader on hospital revenue cycle management teams while also serving as a the Physician Advisor for Clinical Resource Management. Dr. Smith is also an AHIMA ICD-CM/PCS approved trainer/ambassador.
Denise Wilson, RN, MS
Denise has over thirty years of experience in healthcare, including clinical management, education, compliance, and appeal writing
Denise has extensive experience as a Medical Appeals Expert and has personally managed hundreds of Medicare, Managed Medicare, and Commercial appeal cases and presented hundreds of cases at the Administrative Law Judge level. Denise is a nationally known speaker and dynamic educator on Medicare and Commercial appeals processes, payer behaviors, standards of care, appeal template development, and building a road map to drive the payer to a decision in the provider’s favor. She has educated thousands of healthcare professionals around the country in successfully overturning healthcare denials.
