SCHIMA Midlands Region Web Series
Recorded: December 4, 2018 – Recording Now Available!
The Path to Success in Proactive Denials Management & Prevention
CEU: 1.0 – Clinical Data Management
Of an estimated $3 trillion in healthcare claims submitted to insurance payors in 2016, $262B of those were denied. At the same time, the average cost of reworking a denied claim has increased, to over $100 per claim. Keeping cost to collect low and denials overturn success rates high is a multifaceted challenge that requires analytics, technology, and staffing education and support. Join us for an informational presentation geared towards collections and denials professionals to learn proven strategies for protecting revenue and minimizing cost to collect. Hear how providers are tackling denials to improve billing processes for denials prevention.
After this webinar, attendees will be able to:
– Learn how providers can identify root causes of their denials and targeted interventions
– Understand how to best manage payor specific policy changes
– Learn how provides can leverage analytics to uncover trends in their data
– Hear discussion of best practices in workflow and productivity tracking
Glen Reiner, RN, BSNGlen Reiner has been in the healthcare industry for over 25 years, and has recently joined the nThrive Revenue Capture and Charge Audit Services team. Most recently, Reiner served as the Corporate Senior Director of Case Management for Banner Healthcare where he led the Academic Division including acute care, children’s hospital, and psychiatric care facilities. Just prior to his Case Management engagement, Glen directed the Clinical Services Center of Excellence for Adreima, Reiner has also served as the Assistant Director of Nursing for a large healthcare corporation and spent over 16 years as a Registered Nurse, specializing in Nurse Management. His extensive knowledge of healthcare coding, billing, reimbursement, denials, and RAC/MIC audits has been instrumental in the success of many initiatives focused on the intersection of the clinical and financial aspects of healthcare. Glen is an RN and holds a Masters of Business Administration. Reiner is a member of the Arizona chapter of HFMA and is a past Board Member for the AAHAM Western Region.
Recorded: December 6, 2018 – Recording Now Available!
How to Implement Successful Appeal Writing
CEU: 1.0 – Clinical Data Management
This presentation will briefly cover aspects of the denial letter and determining how and what should be appealed. We will point out ways to best determine if the appeal should be a diagnosis/clinical validation versus a coding appeal.
We will also discuss some of current types of denials and ways to successfully appeal them. Examples as well as references will be provided.
Malissa Powers, BS, RHIT, CCSI have over 15 years teaching experience. Most recent with J Sargeant Reynolds Community College Richmond Va since around 2009. Served and continue to serve on the Advisory Committee.
20 years overall HIM experience to include coding, credentialing, HIM supervisor. Worked as a Coding consultant and DRG validator for CERT for a combination of the past ten years. Now full time appeal writer for coding denials. Been with Denial Research over 5 years but just joined full time last year.
Garnette McLaughlin, MBA, RHIA, CCSGarnette has a bachelor’s degree in health informatics, a master of business administration (healthcare management) degree, and is currently working on completing a doctoral degree in healthcare administration. She is a Registered Health Information Administrator, Certified Coding Specialist, and current AHIMA mentor.
Garnette moved to the HIM field in 2011. Prior to discovering this fascinating profession, her background was in IT and management. She has over 15 years of experience in management, training, and customer service.
After completing her BSHI to move into the HIM profession, Garnette began work as an inpatient coder for Intermountain Healthcare, a position that she currently holds. While her primary coding specialty is inpatient she also codes ED, ancillary, and outpatient surgery as needed. Additionally, she provides training and mentoring to beginning coders and clinical documentation improvement specialists.
Recently, Garnette began a position as Coding Appeals Team Lead for Intersect Healthcare after being a contactor. She writes appeals and serves as a resource for other staff members. She also has direct interaction with clients to facilitate successful appeals.
Recorded: December 11, 2018 – Recording Now Available!
Roles Within the Revenue Cycle for HIM Professionals
CEU: 1.0 – Clinical Data Management
During this presentation we will define revenue cycle management, discuss major functions of revenue cycle management, highlight the importance of revenue cycle management and key measures, discuss the role of HIM professionals within the revenue cycle and describe what a successful revenue cycle management program entails.
Tracey Tomak RHIA, PMPTracey Tomak is a Registered Health Information Administrator and Project Management Professional with over 20 years of experience in revenue cycle with a focus on hospital coding, charge capture and denials management.
In her current role as Director, Project Management and Client Engagement, Tracey is responsible for coordinating project implementation of Intersect Healthcare’s Veracity software. Tracey works directly with clients to ensure that they are fully utilizing the Veracity software in order to effectively manage commercial and government audits and denials.
Tracey is an active member of IHIMA, serving as the Nominating Committee Chair for the 2018-19 year. Tracey is a regular guest speaker, lecturer and author on revenue topics such as the Medicare Two-Midnight Rule, RAC and other audit activity, roles within the revenue cycle for health information management professionals, APCs, denial prevention methodology and clinical documentation improvement trends.
Recorded: December 13, 2018 – Recording Now Available!
Keeping Secure in a Cloud Based World
CEU: 1.0 – Privacy and Security
Attendees will hear about security in a cloud computing environment. The presenters will lay out the pros and cons of cloud computing, go into hidden costs involved with securing a cloud environment, and discuss some of the pitfalls from a regulatory and legal landscape and things that can be done to evade those issues. Finally, they will go over access controls and data protection in a cloud environment.
As we move forward with technologies, there are some trends that seem to move to the forefront of technology. Cloud based applications have been around for over a decade now and it appears that they are here to stay. With that, the securing of data in a cloud-based world is imperative to the healthcare industry. Is it safe to place PHI in the cloud? What about access control? Is encryption available? What about monitoring?
Scott Ruthe and Daniel Sergile will move through the murky and sometime perilous waters of healthcare in the cloud. With their 40+ years of combined security experience we will look at different critical issues and ideas for securing a cloud-based application. Not only from the risk perspective, but the additional costs involved with securing your critical health data in the cloud.
Daniel SergileDaniel Sergile is a 25-year veteran in the information technology field. For the last 19 years, he has been dedicated solely to information security. During that time, he has started up information security programs in multiple sectors of business to include the banking and telecommunications sectors. Mr. Sergile built the information security program at Cox Communications. He has secured companies globally to include Canon Europa and Rabobank International. Before coming to CiOX, he built the security program for CertusBank as their CISO. Mr. Sergile is also a veteran of the United States Army and held the additional duty as an information systems security officer.
Series Pricing (4 webinars)
AHIMA Member: $50
Individual Webinar Pricing
AHIMA Member: $20
These webinars will be available on-demand. This means the webinars will be recorded and sent out to all paid registrants, even if they register after the live webinar has occurred, or if they cannot make the time and date set for the live webinar.
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Access instructions to the recording will be provided within 2 business days following receipt of payment.