Product Details

 

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.

Get your department on board today!

 

After this webinar, participants will be able to:

1. Describe how case managers can provide strategies for preventing denials.
2. Discuss the key roles for preventing denials, including the roles of the interdisciplinary care team.
3. Identify key case management strategies for denial prevention and management.

Agenda Topics: 

- Definition of revenue cycle	- Key roles impacting denials	- Types of clinical reviews
- Psychosocial assessments	- Strategies for reducing denials	- Utilization management
- Patient flow	- Discharge planning	- Two-Midnight rule
- Transitional planning	- Quality management	- Access point
- Denial management	- Observation	- Team member roles
- Categorizing denials	- Care coordination	And there's more!

 

Your order includes: 

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, 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.

 

Target Audience:

Anyone involved with or interested in case management, including but not limited to: CEOs, CFOs, COOs, CMOs, CNOs, CE Directors, Department Directors, Quality Improvement Staff, Physicians, Nurses (all levels), Compliance Officers, CMS Liaisons, TJC Liaisons, Registration Staff, Safety Officers and Staff, Pharmacy Staff, Ethics Committee Members, Consumer Advocates, Risk Managers, Legal Counsel, Behavioral Health Staff, Psychiatry Staff, Social Workers, Discharge Planners, Case Managers, Hospice Staff and Regulatory Affairs Staff.

Credit Designation:

Relias Learning, LLC, is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

Expiration:

This CE activity is valid until October 18, 2018 for both the live event and recorded (MP4) version.