Persuade Payers to Pay Up with Successful Appeals Process

Winning appeals – and receiving reimbursement − is now a lot easier for your practice.

CMS has nearly cleared its backlog of Medicare appeals and will now speed up processing new claims. This allows you to reclaim a significant amount of reimbursement from your denials FASTER with a few simple changes to your appeals process. The money is rightfully yours – you just have to know how to go after it.

Even if you have an appeals management plan in place, experts agree that there can be a significant amount of money you are leaving uncollected. Carriers are actually counting on you being too busy to go after these additional funds. In many circumstances, modifications to your appeals argument, regulatory support and knowing how to decode the appeal decision can generate lucrative results.

That’s where national appeals management expert, Sean M. Weiss, CHC, CMCO, CEMA, CPMA, CPC-P, CMPE, CPC, comes in. During his online training session, Sean will walk you through the EXACT steps of how and when to appeal claims so you capture more of the reimbursement you deserve. He’ll give you the anatomy, verbiage, and policy details you need to create appeals that convince payers to pay up.

Here are just a few of the winning claims appeals management tactics you’ll receive by attending this 75-minute online training:

  • Hold your carriers accountable to their response deadline
  • Convince payers to pay up with proven tips to research regulations
  • Get appeal letter verbiage that will really get your claims paid
  • Optimize your resources, identify exactly what and how many claims to appeal
  • How to get 2nd level appeals overturned more easily
  • Define when and how you can add addendums to your records
  • Write a winning appeal argument and get more denials overturned
  • Determine when it’s cost effective for your resources to pursue past the 1st level appeals
  • Stop your message from getting lost by submitting too much information
  • Easy way to track your appeals timeframes and meet submission deadlines
  • Master Medicare, private-payer and Medicare advantage appeal nuances
  • Find out how to use appeal reopenings to collect even more revenue
  • Discover rules for when and how insures can change denials reasons
  • Cut through the confusion between appeals for in- and out-of-network claims
  • Uncover precertification appeals tactics that get your claims approved
  • Improve your appeals process with Payer-Specific strategies
  • Demand clinical and coding reviews to overturn more claims
  • And so much more…

Many of the denials you receive can be overturned, and you can be paid for them, but you must know-how. By attending this 60-minute online training, you will receive the tools and tactics you need to get paid for more of your claims.

If anyone can provide insight and solutions to your appeal questions, it’s Sean. His past experience includes employment with one of the nation’s leading CMS contractors, working as a 2nd level appeals adjudicator. Now he wants to help you.

Don’t wait, sign up for this must-attend online training today.

Added Bonus: Register for this online training, and you will also receive two downloadable appeals templates that have all the appeal anatomy you need to successfully overturn your reimbursement rejections. These tools will help you more easily write winning modifier 25 and 59 appeal letters that persuade payers to pay up.

*Tool will be included with your presentation handouts.

Meet Your Expert

Sean M. Weiss
CHC, CMCO, CEMA, CPMA, CPC-P, CMPE, CPC

Sean has dedicated his career to serving and advocating on behalf of health care providers, hospital networks, and integrated health systems to ensure a level playing field and due process. Over the past 27-years Sean has focused on helping organizations achieve measurable financial results to ensure stability in their market all while significantly reducing the risk of non-compliance. Sean’s knowledge of the inner workings of government agencies at both the state and federal level make him an invaluable asset to clients.

Sean leads the strategic litigation defense and audit team for DoctorsManagement, LLC. Sean is engaged by the largest and most revered law firms in the nation on matters tied to the False Claims Act and Health Care Fraud Statute cases to ensure the best possible defense for clients targeted by government agencies, their contractors, and commercial payer special investigative units. Sean serves as a third-party Compliance Officer for numerous nationally-recognized organizations across the country creating and ensuring a “Culture of Compliance” to mitigate risk and culpability.

Reviews

The content was easy to follow and provided excellent real life examples.
Phyllis Davenport
Administrator, Peripheral Vascular Associates
The webinar was helpful, interesting, and timely.
Sheila Johnson
Billing Coordinator, Heartland Alliance