Managed Care Anguish – Part 2

FRIDAY June 10, 2016:

Managed Care Anguish – Part 2


Looking for an Rx for your Revenue Cycle?


Here’s some real world advice & examples

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Sponsored by The Health Law Partners, MAS Coding Solutions

THIS WEEK, Day Egusquiza & Dr. Maria Johar are again our special guests, for a full hour of discussion about how to “treat” the ever-growing issues in managed care reimbursements, AND they are here to offer some case examples from the real world!

(Ok, well, mostly from the Midwest, but that’s pretty real, yeah? Isn’t it?)

Day EgusquizaDay will be sharing what she’s teaching hospitals about:

  • Like the Flu, you can’t” get rid of” Managed Care, but you can certainly treat it!
  • What are the KEY ELEMENTS to support IP?
  • Are those elements different for different payors?
  • Are you tracking and trending? If so, WHAT do you track and what do you do with what you SEE?
  • An example from a hospital: Drugs denied as “not appropriate for treatment”

Dr. Maria Johar, System Physician Advisor at ProMedica.

Dr. Johar will then be sharing examples from her experiences, and how she successfully reversed these denials:

  • Payor denial due to “Lack of Notification”
  • Payor denial due to “No Pre-Authorization”
  • Payor denial of an IPOL procedure, 1-Day Stay, and Lack of Medical Necessity

Plus… you’ll all get to see a brief preview of what’s in the upcoming PA/UR Boot Camp in San Antonio, this July.

So join us, share your own insights and bring your questions for us!

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