If you’re not adhering to Medicare’s new 2017 Part B claim appeal guidelines to bypass their backlog of unprocessed appeals, you’re losing money – or at the very least, you’re going to have to wait an extremely long time to get it.
There is no way around it, denials are a fact of life when filing Medicare claims. And while you may never rid yourself of denials completely, Medicare’s updated appeal guidelines may improve the speed in which your appeal is processed and in turn, increase your overall revenue. The CMS published the Medicare Program: Changes to the Medicare Claims and Entitlement, Medicare Advantage Organization Determination, and Medicare Prescription Drug Coverage Determination Appeals Procedures Final Rule in January 2017. According to Medicare, “The final rule streamlines the administrative appeal process, increases consistency in decision making across appeal levels, and improves efficiency for both appellants and adjudicators…”
Mastering the Medicare appeals process more quickly and accurately is a two-step approach. First, you need to have the knowledge and understanding of the appeals process. In line with that, and understanding of the changes to the appeals process and how these changes may affect your ability to appeal your denied claims.
This is where Medicare auditing expert, Kelly Grahovac, can help. Before becoming a senior consultant specializing in Medicare audits, appeals, compliance, education and enrollment, she worked for ten years at the Medicare contractor, in such roles as an Adjudicator, Trainer, and Provider Relations Rep. Kelly has taken the knowledge she acquired during that time and will share her inside perspective and Medicare appeals expertise with you during her 60-minute online training session. You can get everything you need to master this complex process and get more of your denied claims paid more quickly and accurately.
Here are just a few of the actionable, step-by-step tactics you’ll receive by ordering this 60-minute online training:
- Avoid missing redetermination deadlines to get more of your denials overturned
- Maximize results by requesting a Qualified Independent Contractor (QIC) to reconsider your claim
- Avoid negative appeal results by adhering to statute 42CFR §405.966(a)(2)
- Head off appeal disagreements with an ALJ Hearing
- Pin down “good cause” defense and get additional denials overturned
- And so much more….
Currently, the average time Medicare takes to process an appeal is 1057.2 days. The new 2017 Medicare appeal guidelines modify a variety of things that they’re responsible for. But leaving it all up to Medicare is a big mistake. If you want to get more of your denials overturned, you must take action.
Don’t wait, order for this must-have online training session with a national Medicare appeals expert walking you through specifically what you can do to get more of your claims paid. Don’t wait, order today.
AAPC: This program meets AAPC guidelines for 1.0 CEUs. On Demand product requires successful completion of a Post- Test for Core A and all specialties except CIRCC for continuing education units.
Meet Your Expert: Kelly Grahovac, MBA
As a senior consultant, Kelly works to counsel healthcare providers as they navigate complex regulatory issues related to Medicare and Medicaid. Her firm, The van Halem Group, LLC, focuses on audits, appeals, compliance, education and training, and enrollment. In addition to client work, Kelly writes for various industry publications and is a known industry lecturer.
“Good dense information.”
- Erin Barber, Assoc Dir of Billing & Compliance, Emergency Medicine Associates, Germantown, MD
“Good information; well-organized and good speaker, easy to listen to, very good.”
- Susan Blue, Manager, Neurological Services of Texas, P.A., Azle, TX
“She sounded as though she was very experienced at what she was talking about and was not just reading the slides but giving her own advise which was a plus.”
- Trashena C., Patient Account Specialist , Memorial Neurological Association, Houston, TX
“It was very informative, well organized and with enough time to answer questions.”
- Carmen Garcia, Office Manager, South Texas Infectious Diseases Consultants, PA, McAllen, TX
“Was well organized and presented well.”
- Julie Keener, Billing Specialist, Regents of the University of Michigan, Ann Arbor, MI
“The information presented was easy to understand and flowed well.”
- Mildred McClarty, Utilization Appeal Specialist, Michigan Medicine, Ann Arbor, MI
“The webinar was done very well, It kept my attention. I learned more about the difference between reopening and redetermination processes, Good Job!”
- Jean Weishaar, Patient Rep - Business Office,Heartland Eye Care LLC,Topeka, KS
“The hand out was good to follow along with.”
- Pattei Yelich, Patient Representative, Pulmonary Associates, Little Rock, AR