Become A Member!

BECOME A MEMBER!

The association is currently focused on acute care inpatient and outpatient
hospital services, with plans to expand to all provider and patient communities.
Welcome to the nation's only association dedicated
to Healthcare Denial and Appeal Management

Welcome to the nation's only
association dedicated to Healthcare Denial
and Appeal Management

The association is currently focused on acute care inpatient and outpatient
hospital services, with plans to expand to all provider and patient communities.

BECOME A MEMBER TODAY!

Welcome to AHDAM.org

The Association for Healthcare Denial and Appeal Management is the nation’s only association dedicated to Healthcare Denial and Appeal Management. We’re here to support and promote professionals working in the field of healthcare insurance denial and appeal management through education and collaboration.

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Upcoming Complimentary Webinar

SEAL Training – The Simple Effective Appeal Letter

Wednesday, May 18th, 2022 at 2 PM Eastern Time

CEU’s for AHDAM Members Only

Summary: As the number of audits and denials continue to increase it’s more important than ever to ensure your denial and appeal management efforts are effective and efficient. Simply regurgitating the clinical information in the record is neither effective or efficient. A focused argument on signs, symptoms, and health concerns that support a decision to admit the patient as an inpatient serves as the base for an efficient appeal letter. Connecting the dots between the clinical picture and the medical necessity of the inpatient admission creates the effective appeal letter.

Join us as we share the methodology of the simple effective appeal letter that creates efficiency while effectively combating denials.

Learning Outcomes:  At the conclusion of the webinar, the learner will be able to Write a simple appeal letter with an argument focused on only those signs, symptoms, and health concerns that support a decision to admit the patient as an inpatient. The learner will be able to identify:

  1. The five areas of focus of medical record documentation for support of the inpatient admission.
  2. The two sections of the history and physical that contain the most valuable information to include in the appeal for inpatient admission.
  3. Identify two objective patient assessments that support the patient’s need for inpatient admission.

About the presenter: Denise Wilson, MS, RN, RRT, Senior Vice President Intersect Healthcare & AppealMasters, President of AHDAM

Denise serves as the Senior Vice President at Denial Research Group – AppealMasters. Denise is also President of The Association for Healthcare Denial and Appeal Management. Denise is a Registered Respiratory Therapist, Registered Nurse, and holds a master’s degree in Management Information Systems from the University of Illinois, Springfield. Denise has over thirty years of experience in healthcare, including clinical management, education, compliance, and appeal writing.

Denise has extensive experience as a Medical Appeals Expert and has personally managed hundreds of Medicare, Managed Medicare, and Commercial appeal cases and presented hundreds of cases at the Administrative Law Judge level. Denise is a nationally known speaker and dynamic educator on Medicare and Commercial appeals processes, payer behaviors, standards of care, appeal template development, and building a road map to drive the payer to a decision in the provider’s favor. She has educated thousands of healthcare professionals around the country in successfully overturning medical care denials. Denise’s special area of expertise is in writing and producing successful appeals.

Click Here to Register!

You must register with a business or provider email address.

General email accounts such as gmail or yahoo will not be approved for attendance.

 


Upcoming Complimentary Webinar

Fighting Readmission Denials

Wednesday, June 22nd, 2022 at 2 PM Eastern Time

CEU’s for AHDAM Members Only

Click Here to Register!

You must register with a business or provider email address.

General email accounts such as gmail or yahoo will not be approved for attendance.

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From The Knowledge Center

Appeal Writing 101

Taryn Schraad | April 5th, 2022 Appeal Writing 101 Not to mince words, but medical insurance claim denials are a “thorn in a provider’s side.” Meticulously getting the admission or diagnostic services authorized or approved,…

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The association is currently focused on acute care inpatient and outpatient hospital services, with plans to expand to all provider and patient communities.

The Association for Healthcare Denial and Appeal Management (AHDAM) publishes and distributes materials on its website that are created by our members or invited industry subject matter experts for the benefit of all AHDAM members. AHDAM does not certify the accuracy or authority of these materials. These materials are distributed and presented as research information to be used by AHDAM members, in conjunction with other research deemed necessary, in the exercise of AHDAM members’ independent professional judgment. AHDAM claims no liability in relation to reliance on the content of these materials. The views expressed in the materials are the views of the material’s authors and do not necessarily represent the views of AHDAM. Any references are provided for informational purposes only and do not constitute endorsement of any sources.