FRIDAY February 24 2017:
Subjectivity in Denials
or
How MAP Payors See Reality Differently
Motivational Poster from a Medicare Advantage Plan Payor Auditing Bull Pen – recently secreted out by a RAC Shadow agent…
Finally Friday! Broadcasts are Sponsored by
The Health Law Partners, ZirMed,
and The American College of Physician Advisors
Denise Wilson, RN MS RRT
THIS WEEK, we have a great preview of some free webinars coming up by Denise Wilson, Vice President at AppealMasters / Intersect Healthcare. Denise is doing a 2-part webinar on appeals topics – the first one on March 1st is about how to understand and appeal Medicare Advantage Plan (MAP) denials, especially how to write a winning appeal. The second one on March 9th will have a little different content, focusing more about strategies for appealing.
Anyway, THIS week on our show, Denise is doing a bit of a preview of what she will be doing on the March 1st webinar.
ANYWAY… the question for us this week is:
Do MAP Auditors see reality the same way we do?
Be SURE to join us when Denise will be discussing these key points:
- WHAT policies do Medicare Advantage Plans follow?
- HOW can you make sense of those policies? (Assuming that’s possible?)
- WHAT is their definition of Medical Necessity?
- WHAT is their definition of Clinical Validation?
- HOW to speak their language for your best defense?
- WHEN can you really challenge MAP denials? (when you have a contract)
- HOW can you challenge MAPs you do NOT have a contract with?
So join us, share your own insights and bring your questions for us!
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FRIDAY – 1:00PM to 2:00PM EDT
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