Medical Necessity Appeals Track 
May 16-17, 2024

Defending medical necessity denials goes far beyond writing a clinical summary of the patient encounter. Successful appeal writers understand types of payers, payer rules, and payer language and use that knowledge to their advantage in constructing winning appeals.

This workshop track teaches you to be a successful medical necessity appeal writer. You’ll leave this session with the skill to attack medical necessity denials with confidence through proven winning appeal strategies.

This track offers 6.0 CEs/CMEs for: NEMSD, NAHRI, PACE, AMEDCO

Speakers:

Denise Wilson, MS, RN, RRT
Senior Vice President, PayerWatch + AppealMasters, Immediate Past 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.

James Cartwright, MD
Physician Advisor, PayerWatch + AppealMasters
James Cartwright, MD has been a physician advisor for PayerWatch over the past five years and has attended numerous ALJ Hearings on behalf of our clients. He also authors appeal letters at different levels of appeal related to NCD/LCD/LCA denials by the Medicare contractors. As a physician advisor at PayerWatch, Dr. Cartwright also attends peer to peer discussions with commercial payers on behalf of our clients and writes complex neonatal intensive care unit (NICU) appeals, appeals for complex adult cases, and appeals for inpatient rehabilitation facilities (IRF) cases.  Dr. Cartwright received his medical degree from the University of Florida and did his pediatric residency at the University of Alabama Children’s Hospital. He now enjoys this new phase of his medical career with PayerWatch after taking care of pediatric and adult patients in private practice and on the mission field.

Registration:

Registration rates are PER TRACK. You will have the option to register for one or more tracks on the registration form.

AHDAM Member Rates:

Non-Member Rates:

Cancellation Policy: No refunds for cancellations will be provided after April 1, 2024. All cancellations must be in writing, emailed to [email protected] with subject line "AHDAM 2024 Workshop Cancellation: name of registrant."

Questions? Visit the AHDAM 2024 Virtual Workshop Series FAQ.