| Please note time changes due to facility availability
AGENDA
9:00 - 9:30 AM - Registration and Networking / Light Breakfast
9:30 - 10:30 AM
Topic: : Healthcare Revenue Cycle Performance Post-UHC Tragedy: Challenges and Strategic Responses
Description: This presentation provides a high-level analysis of healthcare revenue cycle considerations following the tragic events surrounding United Healthcare (UHC). In light of this crisis, the presentation will explore payer responses, public sentiment, and provider considerations, focusing on billing, claims processing, customer service, and transparency. Attendees will gain an understanding of how the tragedy heightened public awareness of healthcare billing challenges and may alter the relationship with the general public.
Speaker: David Kelly, Vice President Revenue Cycle & Ambulatory Operations at Mary Rutan Health
10:30-10:45 AM - Break and Networking
10:45 -11:45 AM
Topic: Managing the Growing Number of Appeals
Description: Navigating the complexities of healthcare claims appeals can be a daunting task for providers. This session will delve into the intricate world of complex appeals, focusing on the challenges of medical necessity and utilization review. Unlike simple errors, such as incorrect birth years, complex appeals often require significant effort to overturn initial denials and secure reimbursement. With the rising number of denials and the increased stages of appeals, providers face an uphill battle to get paid. One of the most pressing concerns is the growing trend of payers, like Blue Cross Blue Shield of Michigan, charging fees for what they deem "overzealous appeals." This practice is likely to spread across the industry, making it even more important for providers to navigate appeals efficiently. The session will explore strategies for crafting clear, concise responses with limited resources, focusing on effective ways to handle medical necessity denials and prior authorization challenges.
We’ll also examine how technology, data, and workflow tools can help identify root causes of denials, but emphasize that these resources are just part of the solution. Ultimately, success in appeals requires a high-level skill set in drafting compelling, targeted appeal letters. With detailed examples from medical necessity and prior authorizations, this session will offer actionable insights on transforming appeals into payments, from individual claims to larger batch settlements. Don't miss this opportunity to gain essential knowledge and tools to overcome denials and maximize reimbursement.
Speaker: Kevin Lasser, CEO at RevKeep |
