Upcoming Complimentary Webinar

Best Practices in the Appeals Process

Wednesday, September 21, 2022 at 2 PM Eastern Time

CEU’s for AHDAM Members Only

Successfully overturning denials goes beyond writing a great appeal. Appeal specialists must employ best practices at every level of both the internal and external appeals process starting with peer-to-peer. Many AHDAM members are asking how best to manage various levels of appeal from a process as well as an appeal argument standpoint. In this session we will present best practices for government and commercial payers’ appeal processes.

About the presenters:

Kendall Smith, MD

Chief Physician Advisor, PayerWatch/AppealMasters

Dr. Kendall Smith is a Senior Fellow in Hospital Medicine (SFHM) and currently acts as Chief Physician Advisor for AppealMasters, a leading appeal educator and appeal services firm for hospitals and health systems. He’s been deeply involved in denial and appeals management throughout his hospitalist career, working collaboratively with UR/Case Management departments as well as Managed Care and Hospital C-Suite executives.

His familiarity with managed care denials led him to design and implement a number of CDI programs, including those at the Cleveland Clinic in Florida and the MedStar Washington Hospital Center. He has served as a physician leader on hospital revenue cycle management teams while also serving as a the Physician Advisor for Clinical Resource Management. Dr. Smith is also an AHIMA ICD-CM/PCS approved trainer/ambassador.

Denise Wilson, MS, RN, RRT

Senior Vice President, PayerWatch/AppealMasters, President, AHDAM

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 healthcare denials.

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