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Case Management's Role in Managing Third Party Payer Denials

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Category case management system, financial case management system, Revenue cycle, Medical necessity, Reducing denials, Preventing denials, case management, third Party Payer Denials, revenue cycle management, healthcare revenue cycle management, revenue cycle management companies, revenue cycle services, case management programs, revenue cycle billing

Deadline: December 04, 2017 | Date: December 05, 2017

Venue/Country: Online, California, U.S.A

Updated: 2017-11-14 21:06:31 (GMT+9)

Call For Papers - CFP

Case management, as a member of the revenue cycle team, plays a strategic role in the implementation of strategies aimed at reducing and/or preventing third party payer denials. Reducing and preventing denials requires proactive and hard-wired processes that engage the entire interdisciplinary care team. The causes of denials are complex and therefore require complex solutions. This program will review the causes of denials and key strategies for reducing and preventing them. Solutions will include key members of the interdisciplinary care team including physicians, physician advisors, case management leaders and case managers. Strategies for analyzing your denial rate will also be included.

Objectives of the Presentation:

Understand the role of the case manager in providing strategies for reducing denials

Discuss the key roles for preventing denials, including the roles of the interdisciplinary care team

Review key case management strategies for denial prevention and management

Why Should you Attend:

Before a department of case management can reduce its denial rate, it first needs to understand what elements within and outside the hospitals are contributing to these denials. Once these root causes have been identified, strategies for correcting them and hard-wiring new practices can be implemented. Reducing denials is an interdisciplinary problem and can only be solved using interdisciplinary solutions.

If your hospital wants to reduce its rate of denials using a strategic approach, this program is for you. Understanding denials in a comprehensive way will positively affect your practice as a case manager or a case management leader.

Areas Covered:

Key case management roles impacting denials

Types of clinical reviews

Denial management

Categorizing denials

Key case management strategies for reducing denials

Roles of team members

Definition of revenue cycle

Revenue cycle process steps


Definitions of medical necessity

Steps in care coordination where denials can occur

Steps in the discharge planning process where denials can occur

Payer expectations

How case management causes denials

How third party payers cause denials

Who will Benefit:

RN Case Managers

Directors of Case Management

Case Management Senior Leaders

Directors of Finance

Physician Advisors

Director of case management

Case managers

Directors of nursing

Directors of patient flow

Director of revenue cycle

Chief financial officers

Chief operations officers

Chief medical officer


Director of quality management

Nursing home directors

Director of home care

For Registration:

Note: Use Promo Code HYED6Z and get 10% off on registration (Valid till DECEMBER 31st 2017)

Keywords: Accepted papers list. Acceptance Rate. EI Compendex. Engineering Index. ISTP index. ISI index. Impact Factor.
Disclaimer: ourGlocal is an open academical resource system, which anyone can edit or update. Usually, journal information updated by us, journal managers or others. So the information is old or wrong now. Specially, impact factor is changing every year. Even it was correct when updated, it may have been changed now. So please go to Thomson Reuters to confirm latest value about Journal impact factor.