Successfully Identifying Winnable Denials Everyone in the denial and appeal management world knows that some denials have a greater chance of being overturned than others. The knowledge comes from experience, but many times it’s just a sense or a feeling of déjà vu. You’ve seen this denial so many times, you know the payer will uphold or you know they will overturn. Have you ever considered grading your denials by opportunity for overturn based on objective data? Using a grading system can help you focus scarce resources on those denials that you are most likely to win. It can also give you insight into payer trends, payer behaviors, and appeal writer quality. Join us as we teach you how to identify winnable denials.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, RRTDenise 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.