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Managing and Preventing Third Party Payer Denials

Managing and Preventing Third Party Payer Denials

Managing and Preventing Third Party Payer Denials

Toni Cesta, PhD, RN, FAAN and Beverly Cunningham, MS, RN
Toni Cesta, PhD, RN, FAAN and Beverly Cunningham, MS, RN
on behalf of Relias Academy

$30.00 $ 30.00 $ 30.00

$30.00 $ 30.00 $ 30.00

$ 30.00 $ 30.00 $ 30.00
$ 30.00 $ 30.00 $ 30.00
Normal Price: $30.00 $30.00

Review:

Launch date: 14 Aug 2018
Expiry Date:

Last updated: 15 Oct 2018

Reference: 191817

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Description

Third party payment denials remain a critical challenge for case managers in healthcare, especially with recent denials coming from Medicaid and Medicare. The impact of denials has increased with the implementation of the two-midnight rule and requirements associated with placing patients in the right level of care based on their medical needs and expected length of stay.

This program will review how your case management department can implement strategies aimed at preventing denials. These strategies require proactive and hardwired processes that engage the entire interdisciplinary care team. Our experts will navigate through the causes of complex denials and provide solutions for preventing them. As a member of the revenue cycle team, case managers must be equipped with resources to manage denials.

Objectives

Describe how case managers can provide strategies for preventing denials.
On completion of this course, the learner will be able to describe how case managers can provide strategies for preventing denials.
Discuss the key roles for preventing denials, including the roles of the interdisciplinary care team.
On completion of this course, the learner will be able to discuss the key roles for preventing denials, including the roles of the interdisciplinary care team.
Identify key case management strategies for denial prevention and management.
On completion of this course, the learner will be able to identify key case management strategies for denial prevention and management.
Toni Cesta, PhD, RN, FAAN and Beverly Cunningham, MS, RN

Author Information Play Video Bio

Toni Cesta, PhD, RN, FAAN and Beverly Cunningham, MS, RN
on behalf of Relias Academy

Toni Cesta -
Toni Cesta, PhD, RN, FAAN is a founding partner of Case Management Concepts, LLC. Dr. Cesta is the author of eight books, a frequently sought-after speaker, lecturer and consultant and is considered one of the primary thought leaders in the field of Case Management. Dr. Cesta also writes a monthly column called Case Management Insider in AHC Media’s Hospital Case Management newsletter. She has been active in the research and development of Case Management for over 20 years.


Beverly Cunningham -
Beverly Cunningham, MS, RN is a founding partner of Case Management Concepts, LLC. She has a 25-year deep working knowledge of case management with specific expertise in denials management, patient flow and the role of the Case Manager and Social Worker in the Case Management process. She has served as a Commissioner on the Commission for Case Management Certification and is a fellow with the Advisory Board. Bev is also the former Vice President of Resource Management at Medical City Dallas Hospital.

Current Accreditations

This course has been certified by or provided by the following Certified Organization/s:

Faculty and Disclosures

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Conflicts Declared

Conflicts of Interest declaration by Author:

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