Appeals: Persuade Payers to Pay-up on More Denied Claims

Date: Tuesday, March 28, 2023 1:00PM ET Length: 60 Minutes Expert: Sean M. Weiss, CHC, CMCO, CEMA, CPMA, CPC-P, CMPE, CPC

Carriers are counting on you being too busy to appeal all of your denied claims. The more reimbursement obstacles they put in your way, the less they have to pay out.

There is a way for you to reclaim a significant amount of reimbursement from these denied claims with a few simple changes to your appeals’ process. Even if you have an appeals management plan in place, experts agree you are most likely leaving a significant amount of money uncollected. In many circumstances, slight modifications to your appeals argument, regulatory support and knowing how to decode the appeal decision can generate lucrative results.

The money is rightfully yours – you just have to know how to go after it.

This is where national appeals management expert Sean M. Weiss, CHC, CMCO, CEMA, CPMA, CPC-P, CMPE, CPC can help. During his upcoming online training session on Tuesday, March 28th at 1pm ET, Sean will walk you through the EXACT steps of how and when to appeal your denied claims to 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 appeals management tactics you’ll receive by attending this upcoming, 60-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
  • Identify exactly when and how many denied claims to appeal
  • How to get 2nd level appeals overturned more easily
  • Define when and how you can add addendums to your records
  • Write winning appeal arguments and get more denied claims 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
  • Use Payer-Specific appeal strategies to get more denied claims overturned
  • Improve your appeals process with Payer-Specific strategies
  • Demand clinical and coding reviews to overturn more claims
  • And so much more…

More of your denied claims can be overturned, and you can be paid for them, but you must know-how. By attending this upcoming, 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.

Meet Your Expert

Sean M. Weiss

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.