Claims Denial Management – In and Out of Network (OON)

Presenter :Stephanie Thomas, CPC, CANPC
Event Date : 03/04/2019
Time: All Day Long
Duration :60 minutes



Product Description

Managing denials continues to be a thorn in the side of just about every healthcare organization. Many traditional approaches to denial management are no longer effect today and treat the symptom rather than the underlying causes – and the back-and-forth with payers can lead to frustration. This webinar will go through the detailed denial workflow for both In and Out of Network (OON).

This session will take the attendees through numerous scenarios, step by step, of how to properly identify trends, work denials effectively to maximize results and how to prevent the denials in the future. The expert, Stephanie Thomas, CPC, CANPC will give specific examples of good and bad denial work and make the attendees to be able to think of their own practice and issues they are facing and be able to walk away after the presentation feeling more confident about working and preventing denials.

Learn how to more effectively work through your denials. Expert Stephanie will also talk a lot about the importance of pre authorizations, insurance verification and their role in the billing process. We will work through numerous denial scenarios: demographics denials, authorization denials, medical necessity denials, out of network, and how to most effectively take care of them.

Feel confident how to work through your denials and how to prevent them in the future. By putting good safeguards into place you will find that you will increase revenue and limit the amount of denials are coming in to your practice. We want you to feel like you can take the information given in this presentation and apply it to your practice.

Session Objectives:

Participant will be able to learn:

  • How to more effectively work through your denials and how to prevent them in the future
  • Pre-authorizations and insurance verification and it’s role in billing process
  • To approach different denials scenario such as demographics denials, authorization denial, medical necessity denials, out of network denials etc.
  • To grasp better understanding of In and Out of Network(OON) billing and developing workflow to maximize reimbursement 
  • Tips and tricks for billing out of network and why this may be the best option for your bottom line
  • To take benefit of PM software and clearinghouse resources.

Session Agenda:

  • Denial Process
  • Denial Reasons
  • How to Prevent Future Denials
  • Working through Denials
  • Identifying Current Trends and Challenges to Deal with Denial
  • Utilizing PM software and clearinghouse resources
  • Appeals
  • Follow up on appeals
  • In and Out of Network(OON)
  • Pros and cons of out-of-network billing

Suggested Attendees:

  • Office Managers
  • Administrators
  • ASC Owners
  • Credentialing Manager or Specialists
  • Billing Manager
  • Physician
  • Healthcare Staff
Related Courses:

About the Presenter:

Stephanie Thomas, CPC, CANPC is the Billing Director for CE Medical Group, a third party billing and consulting firm. She has been in the medical field for 20 years. She has experience in multiple specialties of medical billing and coding and is a certified Pain and Anesthesia Coder as well as a Certified Professional Coder. Billing is her passion, which is why she’s efficient at maximizing reimbursements while educating providers and staff on proper coding techniques. She motivates and coaches our billers to ensure they achieve high level of standards.  If Stephanie is out of the office, she’s most likely in the cheering section at her sons’ baseball games.

After Registration

You will receive an email with login information and handouts (presentation slides) that you can print and share to all participants at your location.

System Requirement

Operating System: Windows any version preferably above Windows Vista & Mac any version above OS X 10.6
Internet Speed: Preferably above 1 MBPS
Headset: Any decent headset and microphone which can be used to talk and hear clearly

Can’t Listen Live?
No problem. You can get access to On-Demand webinar. Use it as a training tool at your convenience.

For more information you can reach out to below contact:
Toll-Free No: 1-302-444-0162
Email: [email protected]

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