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The Denials Management Training Handbook (Pack of 5) Tanja Twist, MBA/HCM Many hospitals struggle with denials management thanks to the complex regulations and various types of denials. Payers often send denials to the wrong person, and hospitals may lose valuable research and appeals time as a result. In addition, drafting effective appeals letters that follow Medicare's regulations can be time-consuming and difficult even for experienced staff. Worst of all, the hard work of managing denials and submitting appeals on the back end can all be wasted if there is no system to use denials data to address root causes on the front end. The Denials Management Training Handbook provides clear, concise explanations of the complex appeal guidelines for Medicare and other payers. This information is presented in an easy-to-understand handbook for distribution to staff members involved in preventing and handling appeals. This handbook will help you manage the denials management process by: Providing an overview of common denial types and appeal timelines Giving you sample forms and templates Exploring best practices for improving the denials management process throughout the revenue cycle Gliding in the use of denials data to track recurrent denials and address their causes
The Model Rules of Professional Conduct provides an up-to-date resource for information on legal ethics. Federal, state and local courts in all jurisdictions look to the Rules for guidance in solving lawyer malpractice cases, disciplinary actions, disqualification issues, sanctions questions and much more. In this volume, black-letter Rules of Professional Conduct are followed by numbered Comments that explain each Rule's purpose and provide suggestions for its practical application. The Rules will help you identify proper conduct in a variety of given situations, review those instances where discretionary action is possible, and define the nature of the relationship between you and your clients, colleagues and the courts.
Helms takes us through her unfiltered, uplifting story of chronic pain and severe depression to becoming a nationally recognized coalition builder and health care advocate as she battled to change a system that had failed millions. With stark honesty, she describes her personal struggle for appropriate care and the redemption she found challenging some of America’s most powerful, for-profit corporations on behalf of patient fairness and access to affordable, appropriate standards of quality care for all. “The power of one” an often over-used cliché, but the soul’s message of Unhinged; one woman joined by many to face down one dragon at a time; one voice joined by a chorus to alter forever, the conversation. Helms plots a roadmap for anyone who, even while questioning their own value or power, can move mountains unimagined by owning their voice, their sense of justice and their purpose. Armed with truth, directed purpose and willful respect, Helms proves that the ‘Lion’s den’ is but a myth, waiting to be challenged and exposed as such on behalf of all concerned.
"Ultimate Guide to Dental Billing and Reporting provides a proven, accessible, and easy-to-implement dental billing template for any dental office. All practices will benefit from the simplicity and positivity of this important guide. I really like the actual number examples and the templates for how to structure your day. It's great information and a must-have for all dental offices." -Dr. Christopher Comer, DMD FAGD, Savannah, GA "This book makes billing and insurance very easy to understand. It maps out a very concise approach to insurance and billing in the dental office. I have taken many CE courses on these topics over the years. This book not only gave a more complete picture of the billing and insurance process than I have seen previously but also gave an easy way to approach and implement the process in the dental office." -Dr. Michael Groover, DMD From Chaos and Confusion to Confidence and Cash Flow Making appointments. Filing claims. Answering the phone. Checking patients in and out. If you're an office manager or insurance coordinator, you know how challenging it is to run a dental office. And if you're new to the industry? Welcome - we're here to help you learn the ropes. Here's the truth: Every dental office's success depends on: Healthy production and collections Smooth patient flow Delivering the ultimate patient experience with a smile The lifeblood of any successful practice is a rock-solid dental billing process. This book is a step-by-step guide to a groundbreaking dental billing process written by a leader in the industry. You're about to learn how dental billing impacts the overall health of your practice. You'll finally understand the gems hidden inside your dental reporting and how to use them. Best of all? You'll leave billing chaos behind and take a major step toward healthy cash flow and confident mastery of your processes.
Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). This brief guide explains Section 1557 in more detail and what your practice needs to do to meet the requirements of this federal law. Includes sample notices of nondiscrimination, as well as taglines translated for the top 15 languages by state.
Hospitals lose an average of $1,000 a day because of denied claims. Outpatient sites lose an average of $1,200 per day from the same problem. Health plans have very strict approval guidelines. They give providers a large number of forms and letters to wade through and make the claims appeals process generally confusing and time-consuming. Providers need a time-saving resource to help them appeal and reverse unfavorable medical necessity-related health plan claims decisions. Appealing and Preventing Denied Claims, which is applicable to hospital and physician practice settings, uses case studies and scenarios to show: