Click Here to download the 2012 Educational Seminar Catalog                                     Click here to sign up!

 

The Certified Professional in Denial & Appeal Management (CPDAM) Program focuses on identifying effective techniques to communicate with both clinicians and non-clinical staff in order to appeal current denials and prevent future denials. Your professionals are taught how to apply techniques to develop and implement a structured Denial Management and Appeals Improvement Program within hospitals. Evidence Based Case studies, InterQual criteria and practical instruction are provided in developing and/or enhancing your compliance methods in auditing, monitoring, and evaluating the implementation & effectiveness of your denial management program. Our extensive professional experience and training in clinical care, case management, medical necessity, coding guidelines, and regulatory compliance are the foundation for our highly successful recovery audit defense and appeals process.

 

Overall Learning Objectives
 
At the completion of this program, participants should be able to:
 
  • Identify the challenges inherent to interpreting the payer payment systems, denial management and how to have your facilities prepared for success with appeals.
  • Understand the changing state of today’s healthcare system, as related to the important trends toward required compliance activities to prevent future claims denials.
  • Identify the diverse educational needs for healthcare personnel regarding the significant changes in the healthcare reimbursement field and how these impact the denials that an organization will confront.
  • Identify important methods of, and how to manage, administrative & provider organizational acceptance and “buy-in” to improve the denial management and appeals processes.
  • Describe the goals, key benefits, and strategies of having an on-site based denial management and appeals program.
  • Identify effective techniques to communicate with both clinicians (physicians, mid levels, nurses, care managers) and non-clinical (coding & billing) staff in order to appeal current denials and prevent future denials.
  • Apply techniques to develop and implement a structured Denial Management and Appeals Improvement Program within acute care hospitals.
  • Identify compliance methods on auditing, monitoring, and evaluating the effectiveness of your denial management program.

 

 Process Requirements

 

  • Accurate, precise and explicit medical records documentation
  • Effective case management processes including level of care assignment
  • Correct and compliant coding that reflects the true severity of illness and complexity of care 

 

Our approach 

 

  • Evidence-based
  • Incorporating InterQual clinical criteria and regulatory requirements
  • Concise, focused, rapid-response strategy
  • Evaluate demand letters and denials for likelihood of successful appeals
  • Prepare comprehensive responses to RAC, MAC and other auditors designed to maximize the chances of successful reversals as quickly as possible
  • Identify your denial and recovery audit vulnerabilities and implement corrective action strategies to preempt future assessment risks 

 

Attendees have the option of taking the Certification Exam within 6 weeks of this Program.

 

For more information about our programs contact:

Jim Lewis

757-695-4995

JLewis@DocucompLLC.com              

                                                                           

 

 

Certified Professional in Denials & Appeals Management (CP-DAM) Program
2012 Accreditation Statements

AMA PRA Category 1 CreditsTM


This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the Southern Medical Association and DocuComp, LLC. The Southern Medical Association is accredited by the ACCME to provide continuing medical education for physicians.


The Southern Medical Association designates this Live activity for a maximum of 12.5 AMA PRA Category 1 CreditsTM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ANCC


This activity will provide 12.5 contact hours.
This continuing nursing education activity was approved by the Ohio Nurses Association (OBN-001-91), an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.
Approval valid through March 23, 2014. Assigned ONA # 15,412.

AAPC


This program has the prior approval of AAPC for 12 continuing education hours. Granting of prior approval in no way constitutes endorsement by AAPC of the program content or the program sponsor.

AHIMA


This program has been approved for 12 continuing education units for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA).

CCB


Compliance Certification Board (CCB) has approved this program for 15.0 Compliance Certification Board (CCB) Continuing Education Units in one or more of the following areas:

  • Application of Management Practices for the Compliance Professional
  • Application of Personal and Business Ethics in Compliance
  • Written Compliance Policies and Procedures
  • Designation of Compliance Officers and Committees
  • Compliance Training and Education
  • Communication and Reporting Mechanisms in Compliance
  • Enforcement of Compliance Standards and Discipline
  • Auditing and Monitoring for Compliance
  • Response to Compliance Violations and Corrective Actions
  • HIPPA Privacy Implementation


Granting of prior approval in no way constitutes endorsement by CCB of the program content or the program sponsor.

CCMC


This program has been pre-approved by the Commission for Case Manager Certification to provide continuing education credit to Certified Case Managers (CCMs). Approval number 790006363 through December 31, 2012 for up to 12.5 clock hours of continuing education credit.

CDI-CB


The Certified Professional in Denials & Appeals Management (CP-DAM) Program has been approved for 12.5 continuing education units for use in fulfilling the educational requirements for the maintenance of the C-CDI credential by the Clinical Documentation Improvement and Integrity Certification Board.

Accreditation:
Total Accreditation Hours per type:
ACCME/ANCC/CCMC/CDI-CB-12.5; AAPC/AHIMA-12.0; CCB-15.0
Statements of credit will be issued to participants who attend the activity, complete the Activity Evaluation and complete a CE request form. Statements of credit will be issued within 30 business days.
Participants will receive continuing education credit only for the sessions actually attended.

 
Welcome to AIHCD

 

A community where CDI professionals can share information with other members and access resources leading to professional growth.

 

Join Today!

We would love for you to join us in helping to interpret, provide compliance to and be impactful of the changes occurring within health care today.

Member Login

Username:
Password:
Remember me
Forgot Password ?

Not a member yet? Sign Up!

Username:
Firstname:
Lastname:
Email:
Password:
Confirm:
A password will be e-mailed to you.

Home | Community | Contact Us | Login

Terms Of Use | Privacy Statement

Copyright 2011 by the Association for Integrity in Health Care Documentation | powered by DocuComp, LLC