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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.
|- 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!|