FHIMA | Lessons Learned from Payer Denials

Overview:

This presentation covers the increasing trend of payer denials, clinical validation and topics that trigger payer denials. It also discusses some criteria that payers are using for clinical validation and some proactive steps that can be taken. In conclusion, best practices for denial management are covered.

Date Published:

February 25, 2021

CEU:

1.0 – Revenue Cycle Management

Speaker:

Laurie Johnson, MS, RHIA, FAHIMA

Laurie M. Johnson is a senior consultant with Revenue Cycle Solutions LLC and has over 35 years experience in Health Information Management (HIM). She has a significant experience managing HIM departments, performing inpatient and outpatient coding audits, Recovery Audit Contractor (RAC) services, software development, revenue cycle turnaround services, transitioning to ICD-10-CM/PCS, and providing coding and reimbursement educational services to clients. She currently serves on the 2020 AHIMA Clinical Documentation Improvement Practice Council. She also led the award winning PHIMA ICD-10 education initiative.

Laurie is a regular guest on Talk Ten Tuesday as the news desk correspondent. She earned a B.S. in Health Records Administration in 1988 and has a M.S. in Healthcare Information Systems, both from the University of Pittsburgh. Her memberships include Fellow of the American Health Information Management Association, the Pennsylvania Health Information Management Association, and the Western Pennsylvania Health Information Management Association.