CPDAM
Certification Program
Certified Professional in Denial & Appeal Management (CPDAM)
At the completion of this program, participants should be able to:
- Identify the challenges inherent to interpreting the payer payment systems,
denial management and how to have your facilities prepared for success with
appeals.
- Communicate the historical perspective on the evolution of the healthcare
payment system with a focus on denials and appeals.
- Understand the changing state of today’s healthcare system, as related
to the important trends toward required compliance activities to prevent claims
denials.
- Identify the educational needs for healthcare personnel regarding the significant
changes in the healthcare reimbursement field and how these impact the denials
a organization will confront.
- Identify important methods of, and how to manage, 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 and non-clinical
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 hospitals.
- Identify compliance methods on auditing, monitoring, and evaluating the
effectiveness of your denial management program.
- Identify the new role of Recovery Audit Contractors (RACs) and how to prepare
your organization for them.
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