Course Provider
Learning Objectives
Articulate the appeal process and related regulations
Define key steps in the appeal process up to and beyond the Administrative Law Judge level
Describe common causes of Medicare denials
Design policies and practices to support compliance, reduce denials, and expedite appeals
Examine denied claims to select appropriate appeals
Equip denial and appeal staff with effective and efficient strategies to effectively review and respond to denials and appeals
Conduct research necessary to respond and effectively draft an appeal
Articulate the common commercial contractual clauses that impact audits and appeals
Construct a solid appeal letter and identify the necessary components to include in appeal letters