Denial Resolution and Management Course
This online course equips you with a thorough understanding of the denial management process in medical billing that involves identifying, analyzing, and resolving denied claims to ensure timely and accurate reimbursement.
The average claim denial costs upwards of $30 to appeal, which can amount to a six-figure annual spend for some healthcare organizations. Consider the added cost of write-offs and you can understand why provider organizations look for medical billers with exceptional denial resolution skills.
By the end of the course, you'll be ready to provide reliable denial management services and play a significant role in optimizing revenue cycles, maximizing reimbursement, and minimizing financial losses. You’ll gain proficiency in tracking claim judgments, learn the different types of denials and the steps to resolve them, and develop a strong understanding of what mistakes lead to denials.
Education and experience requirements
Completion of a professional coding course or 1 year of ProFee coding experience recommended.
Continuing education units (CEUs)
10 CEUs awarded upon completion (one-time use only).
Course syllabus
Required books
AAPC’s Denial Resolution (PDF; included with course)
AMA CPT® Professional Edition (current year)
ICD-10-CM code book (current year)
Course format
This is an online self-paced instruction course. You get the flexibility to complete the course on your own time, at your own pace with on-demand training. Get the help you need from the certified coaching team at any point in your training via email.
Exam format
35 multiple-choice questions completed within 75 minutes. Questions are based on coding cases from real world, redacted records.
Certificate of completion
Certificate issued upon completion with a 70% passing score.
Who should take this course?
Our Denial Resolution and Management Course is for medical coders, billers, practice managers, or any other healthcare business professionals looking for the most up-to-date information related to billing and claim denials.
Course objectives
Review of the revenue cycle for the medical office
Proper claims completion for the CMS-1500 claim form
Review of clearinghouse reports and explanation of benefits (EOBs)
Understand denial types and causes, as well as what steps to take to resolve them
Know how to carry out denial analysis and root cause identification
Gain strategies for denial prevention and reduction
Know effective denial appeal processes, best practices, and techniques
Course content
Reading assignments:
Revenue Cycle for the Medical Office
CMS 1500 & EOBs
Denial Resolution
Interactive lectures:
Healthcare Revenue Cycle Overview
CMS-1500 Claim Form
Denial Resolution
Case studies for practical application of denial resolution
Final assessment
Course terms and conditions
By purchasing any online course and other items, I certify that I have read and agree to the online course terms and conditions and the refund policy.
Date of purchase is considered your course start date, additional time will be given for processing of your order. After your order is processed, you will receive further email instruction for course access.
This online course must be completed within a 1-year period or less from date of purchase. Additional time extensions may be purchased for a monthly fee. Date of purchase is considered your course start date. After your order is processed you will receive further email instruction on course access.