Learning Outcomes:
At the conclusion of the webinar, the learner will be able to begin to create a denial scoring system based on their provider’s unique make-up including payers, current payer trends, denial types, and denial reasons. The learner will be able to identify:
A benefit of utilizing a scoring system to identify denials with the best opportunity for overturn.
A data element crucial to identifying denials with the best opportunity for overturn.
A way to create a simple report that will use meaningful data to identify denials with the best opportunity.
Presenter: Denise Wilson, MS, RN, RRT
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.