Navigating Through Payer Denial Codes and How to Successfully Respond
August 21, 2019 11:00am MT
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.
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