Overview:
This offer is only available to GHIMA members purchasing our 2020-21 GHIMA Education Bundle. This fee covers a minimum of 12 CEUs, and may include up to 15 CEUs to be offered, at no additional charge for the 2020-21 year spanning from November 2020 through June 2021.
What do I receive?
You will have the opportunity to attend live webinars and/or pre-recorded webinars throughout the year with your paid flat rate education subscription. This is only available to GHIMA members and all webinars are available for 60 days from the date of the live event or after payment is received if purchased after the recorded event. You will receive quarterly instructions to access content as added. CEUs are all AHIMA approved and will match one of the 8 AHIMA domains.
Pre-Recorded Sessions:
Session 1: Successfully Appealing Clinical Validation and Coding in Malnutrition
Denial of the malnutrition diagnosis code by a payer on a submitted claim can result in a lower-weighted DRG which translates to a lower-than-expected payment to the provider. Launching a successful appeal for this type of denial requires detailed insight into the coding rules and clinical validation standards that support the appropriate assignment of the malnutrition diagnosis. This 90-minute webinar will describe the current state of medical insurance denials being issued for coding and clinical validation of the malnutrition diagnosis on the inpatient hospital claim. The presenters will discuss successful appeal strategies from a coding and clinical validation standpoint.
Learning Outcomes:
- Understand common denial rationale.
- Recognize the differences between coding and clinical denials for malnutrition.
- Discover successful strategies to compose winning appeals when the Malnutrition diagnosis is denied, even though you got it right.
CEU: 1.5 – Revenue Cycle Management
Session 2: Successfully Appealing Clinical Validation and Coding Issues in Encephalopathy
Learning Outcomes:
- Understand common denial rationale.
- Recognize the differences between coding and clinical denials for encephalopathy.
- Discover successful strategies to compose winning appeals when the encephalopathy diagnosis is denied, even though you got it right.
CEU: 1.5 – Revenue Cycle Management
Live Sessions:
January 28, 2021 – Recording Available
Session 3: Successfully Appealing Clinical Validation and Coding in AKI, ATN, pneumonia
Learning Outcomes:
- Understand common denial rationale.
- Recognize the differences between coding and clinical denials for AKI/ATN and pneumonia.
- Discover successful strategies to compose winning appeals when the AKI/ATN or pneumonia diagnosis is denied, even though you got it right.
1.5 CEU – Revenue Cycle Management
February 23, 2021 – Recording Available
Session 4: Successfully Appealing Clinical Validation and Coding in Acute Respiratory Failure
Learning Outcomes:
- Understand common denial rationale
- Recognize when to appeal with clinical criteria, coding criteria, or both
- Discover successful strategies to compose winning appeals when the acute respiratory failure diagnosis is denied, even though you got it right
1.5 CEU – Revenue Cycle Management
March 23, 2021
11:30 AM – 1:00 PM ET
Session 5: Appealing Denials for Coding of BMI, Obesity and Morbid Obesity
Learning Outcomes:
- Understand the coding rules concerning BMI, obesity, and morbid obesity
- Learn who to involve on the front end, and how to do it, to make your medical record as “bullet proof” as possible
- Discover successful strategies to compose winning appeals when the BMI and associated diagnosis are denied, even though you got it right.
1.5 CEU – Revenue Cycle Management
Speakers:
Denise Wilson, MS, RN, RRT
Denise serves as the Senior Vice President at Denial Research Group – AppealMasters. Denise is also President of The Association for Healthcare Denial and Appeal Management. Denise is a Registered Respiratory Therapist, Registered Nurse, and holds a Master’s degree in Management Information Systems from the University of Illinois, Springfield.
Denise has over thirty years of experience in healthcare, including clinical management, education, compliance, and appeal writing.
Denise has extensive experience as a Medical Appeals Expert and has personally managed hundreds of Medicare, Managed Medicare, and Commercial appeal cases and presented hundreds of cases at the Administrative Law Judge level. Denise is a nationally known speaker and dynamic educator on Medicare and Commercial appeals processes, payer behaviors, standards of care, appeal template development, and building a road map to drive the payer to a decision in the provider’s favor. She has educated thousands of healthcare professionals around the country in successfully overturning medical care denials. Denise’s special area of expertise is in writing and producing successful appeals.
Malissa Powers, B.S., RHIT, CCS, CDIP CICA
Malissa has 20 plus years of experience in the Health Information Management field.
She has worked in multiple capacities within the HIM profession to include years of management and leadership experience.
She has over 12 years of teaching experience in her field. Malissa has successfully authored hundreds of coding appeals at all levels including ALJ overturns. She has authored several articles related to denials and appeal writing for organizations such as the HFMA, and AHIMA along with other various webinars.
CEU:
7.5 CEUs
AHDAM Registrants – contact AHDAM directly [email protected] for any additional CEU forms for NAHRI or ACDIS.
Course Includes
- 6 Lessons
