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Denials Aviodance & Appeals Management Institute

The Denials Avoidance & Appeals Management Institute (C-DAM®) Institute 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.

This program activity will provide 12.5 contact hours (CDI). 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 (ANCC).
Approval valid through June 15, 2018.
Assigned ONA # 20077

This program has been pre-approved by The Commission for Case Manager Certification to provide continuing education credit to CCM® board certified case managers. The course is approved for 12.5 CE contact hour(s). Activity code: C00017012 Approval Number: 150002935

The Denials Avoidance & Appeals Management Institute (DAM) Program has been approved for 12.5 continuing education units for use in fulfilling the educational requirements for the maintenance of the C-DAM credential by the Clinical Documentation Improvement and Integrity Certification Board. (This program was formally known as the “DocuComp LLC/DocuEd Clinical Documentation Institute and Certification Program”). Statements of credit will be issued to participants who attend each session in the entire activity, complete the Activity Evaluation and submit a CE Request Form.  Statements of credit will be issued within thirty (30) business days. Participants will receive continuing education credit only for the sessions actually attended.

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.

Overall Learning Objectives
At the completion of this program, participants should be able to:

Identify the challenges inherent in 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

The C-DAM® Program recognizes and builds on your past experience, and prepares you for future healthcare challenges in medical necessity and clinical documentation. The C-DAM® Program is for professionals at varying levels of health care including:

Physicians
Hospitalists
Physician Assistants
Nurses
Nurse Practitoners
Clinical Documentation Specialists
Case Managers/Utilization Reviewers
Health Information Managers/Coding Professionals
Quality Assurance Professionals
Compliance Professionals 

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

Payment/Substitutions/Cancellation

Registration accepted until seminar is full.

Registration Fee: $1,295

Clinical Documentation Specialist Certification Examination: $395
Total: $1690


 

No refunds will be given for cancellations. A conference credit may be given when requested in writing prior to the seminar for which you are registered. No refunds will be given for no-shows. Registration fees must be paid by posted deadlines. Registration may be transferred to a member of your organization up to 24 hours in advance of the seminar.

For more information about our programs contact:
740-968-0472
info@docucompllc.com