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.
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:
- The five areas of focus of medical record documentation for support of the inpatient admission.
- The two sections of the history and physical that contain the most valuable information to include in the appeal for inpatient admission.
- 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.
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
You must register with a business or provider email address.
General email accounts such as gmail or yahoo will not be approved for attendance.
Member Login
Join our Mailing List
Latest Industry News
Some Medicare Advantage Organization Denials of Prior Authorization Requests Raise Concerns About Beneficiary Access to Medically Necessary Care
WHY WE DID THIS STUDY A central concern about the capitated payment model…
A Recent Appeal Decision Out of The United States Court of Appeals for The Fourth Circuit Sheds Light on Several Missteps Made by an Employee Retirement Income Security Act (ERISA) Plan
A recent appeal decision out of the United States Court of Appeals for…
Report on Medicare Compliance Volume 31, Number 13. April 11, 2022 Physicians Don’t Have to Specify Scientific Evidence in Chart, Expert Says
Report on Medicare Compliance Volume 31, Number 13. April 11, 2022 Physicians Don’t…
