SCHIMA | Successfully Appealing Clinical Validation and Coding in AKI, ATN, and Pneumonia

  • 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.

Overview:

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.

Date Published:

January 28, 2021

CEU:

1.5 – 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.

Pricing:

SCHIMA/AHIMA Member: $20
NAHRI Member: $20
ACDIS Member: $20
AHDAM Member: $20
Non-Member: $30

Instructions:

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You will have 60 days to access the course after access has been granted.

Once the course is completed, you will have the ability to download the CE certificate.

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Course Includes

  • 1 Lesson
  • Course Certificate