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所在平台: Udemy |
课程主页: https://www.udemy.com/course/denial-management/
课程评论：没有评论
课程名称：拒赔管理简易指南（医师服务，HCFA-1500） 课程概述：随着时间的推移，医疗索赔拒赔的问题日益严重。据HFMA报道：“提供者通常对超过一半的拒赔不采取任何措施。多达65%的拒绝索赔从未重新提交。”其中包括来自商业健康计划的拒赔，根据上述研究，2017年拒赔中58%来自此类计划，而2016年这一比例为54%。这意味着大量资金被浪费在未追回的拒赔上，整个行业仍在寻找解决方案。本课程将刷新您对拒赔管理的知识，了解适用于医师服务（POS 11）的8种最常见的拒赔类型，并探索这些拒赔类型的解决方案，以及它们是否能够成功解决（提示：并非所有情况都能解决）。通过本课程，您将节省时间，提高收款率。此外，我们还将讨论3个实际案例，包括索赔重新考虑/更正索赔和申诉的实例，涵盖在线提交（通过门户）、电话沟通和传真请求。您还会回顾HCFA-1500表格中第7项和第8项的区别。通过本课程，减少您在拒赔上花费的时间，并将更多时间投入到提高您实践效率的工作中。
As the years go by the medical claim denials are becoming more of a nuisance for the practices everywhere. According to HFMA: "Providers typically do nothing at all to address more than half of denials. Up to 65 percent of denied claims are never resubmitted. Included in this percentage are denials stemming from commercial health plans, which-according the previously cited research-constituted 58 percent of all denials in 2017, up from 54 percent in 2016. This is money left on the table, and the industry is still looking for solutions to tackle the issue." In this course you will refresh your denial management knowledge. Find out the 8 most common denial types (any specialty) for physician services (POS 11). Explore solutions to the 8 most common denial types, if they can be successfully resolved (hint: not all of them can). Save time! Increase your collection rate. In addition we will go over 3 real life examples of claim reconsideration/corrected claim and an appeal. These examples will include an online submission (through portal), a phone call and a fax request. Plus do you remember the difference between 7 and 8 on HCFA-1500 form? Reduce time you spend on denials and dedicate more of that time on making your practice efficient.
