Medicare Top 10 Denials

Event Information
Product Format
Prerecorded Event
Barbara J. Cobuzzi, MBA, CPC, CENTC, COC, CPC-P, CPC-I, CPCO, AAPC Fellow
60 Minutes
Product Description

Medicare Denials Can Be Avoided. Read On!

Denials Management starts with knowing why the denials happen and then taking proactive action and the development of processes in the practice to avoid those mistakes in the claims to avoid denials in the future. Clean and accurate claims assure timely and proper payments. Medicare has a defined set of rules which are published to everyone and available to all providers. One can take those rules to make sure claims are clean and accurate. Compared to other private payers who do not necessarily publish all their rules, Medicare makes it easier to comply with the demands placed on the practices.

Once the practice understands the requirements from Medicare, the next step is quantifying what type of denials happen often, the cause of those denials and what processes and controls can be put in place to avoid and catch the causes of those denials before the claims leave the door, and correcting the claims before electronic transmission. This knowledge and control process will reduce denials and most importantly will get payment in a timely manner and optimized compliant amounts.

Barbara Cobuzzi, CPC, CPC-H,  CPC-I, will provide you with thorough knowledge of what to look out for, how to change processes, policies and procedures, interactions in the practice of different job functions. After this session, the practice will operate and function like a well-oiled machine to avoid Medicare denials by speeding and optimizing compliant income coming to the practice. A by-product of this program will result in reduced non-Medicare payer denials as well.  Although, there is not as much knowledge of non-Medicare denials and rules since they are not published like Medicare’s, better practice operations will result in less denials all the way around, for Medicare and non-Medicare payments. The presentation will give the attendees a roadmap where they want to go for their practice, reviewing denials and changing, adding and deleting processes as well as adding education to reduce denials, increase timely payments and optimize compliant income.

Highlights of the session are:

  • Denials are avoidable if one understands what causes the denials and what the payer is looking for
  • Incorporating policies and procedures along with education to the entire office staff, from file clerk to physician will create a culture of denial avoidance and timely and optimized payments
  • Medicare has a specific set of denials which occur most frequently and these will be examined along with what can be done to avoid them
  • Review of your own specific denials and practice will customize itself to reduce denials
  • It is everyone’s responsibility in the practice to avoid denials
  • What are the main causes of Medicare denials
  • What can the practice do to avoid those denials, incorporating the avoidance process into the practice culture, procedures and process and the way the staff thinks on a daily basis

Who should attend? Practice management, front desk, billing staff, clinical staff and physicians

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About Our Speaker

Barbara J. Cobuzzi - Healthcare Compliance Training Expert

Barbara J. Cobuzzi owns CRN Healthcare Solutions which provides value added provider consulting services. She holds a B.S. in industrial engineering from Rensselaer Polytechnic Institute and an MBA from New York University. She holds certifications from the AAPC as a CPC (certified physician coder), COC (certified hospital outpatient coder), CPC-P (certified payer coder) a CPC-I (certified coding instructor) and a CPCO (certified professional compliance officer). She also holds...   More Info
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