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Navigating Through Payer Denial Codes and How to Successfully Respond

Presenter Susan Roskos, CPC, CPPM
Broadcast Date 8/21/2019
Time 10:00am PT / 11:00am MT / 12:00pm CT / 1:00pm ET
Presentation Length 60 minutes
Price $65 (Non-members $85)
Navigating Through Payer Denial Codes and How to Successfully Respond Webinar

Learn more about this event

In this webinar, we will identify common payer remittance codes that relate to claim denials, explain what they mean, and provide the steps necessary to resolve the issue(s) preventing the claim from processing. Once we understand how to interpret the reason the claim is denied by studying the remittance codes, it is much easier to determine if there was an error or an omission in the original claim submission. Most of the time it is not necessary to contact the payer, which can be very time consuming. We will also identify extra steps that may be taken to prevent future denials of the same claim for a different reason.

Why is this topic important?
Payer remittance codes are powerful communication tools that can be intimidating if not fully understood. Understanding the meaning of these codes will not only guide us through the process to successful claim adjudication but will also allow us to track common error and omission trends within the reimbursement process.

Who would benefit from this topic?
Physicians, mid-level providers, coders, insurance specialists, and billing managers would all benefit from this topic.

How would this benefit the individual and/or their company?
Understanding why claims do not successfully process after the first submission and being intentional to correct and prevent these denials will result in cleaner claims, faster reimbursement, and a more efficient use of resources. The result is optimal reimbursement and reduced overhead costs.

What information or new skills will the attendee take away from this webinar?
The attendee will have a more comprehensive understanding of common remittance codes, step-by-step processes that lead to claim adjudication, and the ability to identify coding and documentation trends that lead to claim errors.

Why is the presenter the expert on this topic?
Susan has over 30 years of experience in healthcare on the provider side of the reimbursement process and have observed increased sophistication in claims processing as it pertains to technology. As a former practice manager, she followed trends in claim denials through remittance codes and based upon those trends made changes in internal automated and manual processes that resulted in a higher percentage of clean claims upon first submission.

Susan Roskos, CPC, CPPM

About The Author

Susan Roskos, CPC, CPPM

Susan entered the business side of healthcare in 1985.  Her work experience includes auditing, billing, coding, E.H.R. implementation, practice operations, practice start-ups and revenue cycle management.  She has held several private practice employment positions and has also been a self-employed practice management consultant.  She formerly taught basic ICD-9-CM and CPT-4 coding courses through Kilgore College in Kilgore, Texas, and Cross Country Education (VYNE) based out of Brentwood, Tennessee.

Her coding experience includes Cardiology, Gastroenterology, General Surgery, Obstetrics and Gynecology, Plastic Surgery, Thoracic Surgery, Urology and Vascular Surgery.  Susan is currently a coding specialist for Navigant - a specialized, global professional services firm.


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