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Defusing Denials
Length: 54 Minutes


** Please note this program was a part of the VOC 2023. You will not want to choose this program if you completed this individual program as part of the VOC 2023. **

This presentation will discuss the most common causes of insurance denials and how to address their documentation and care to decrease these denials. 

Learning Objectives:
•    
Learners will identify the most common insurance denials and the causes of these denials.
•    Learners will implement appropriate staff workflows and documentation to help reduce insurance denials.
•    Learners will spend less non-clinical time addressing insurance denials.
•    Learners will recognize how to reduce patients’ wait time to get recommended treatments or testing to improve patient outcomes.

Accreditation Statement: Missouri Association of Osteopathic Physicians and Surgeons (MAOPS) is accredited by the American Osteopathic Association to provide osteopathic continuing medical education for physicians. MAOPS designates this program for a maximum of 1 AOA Category 1-A CME credit(s) and will report CME and specialty credits commensurate with the extent of the physician’s participation.

The Missouri Association of Osteopathic Physicians and Surgeons (MAOPS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Missouri Association of Osteopathic Physicians and Surgeons (MAOPS) designates this enduring activity for a maximum of 1 AMA PRA Category 1 Credit(s)ä. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Planning Disclosure: The Missouri Association of Osteopathic Physicians and Surgeons Education Planning Committee has no relevant financial relationships with any organization producing, marketing, reselling, or distributing healthcare goods or services consumed by, or used on, patients relative to the content of this presentation.

Grievance Policy: All grievances should be in writing and should specify the nature of the grievance. Initially, all grievances should be directed to MAOPS Executive Director, who will then forward said grievance to the Education & Convention Committee. All grievances will receive an initial response in writing within 30 days of receipt. If the participant does not receive a satisfactory response, then they can then submit a complaint in writing to the Bureau of Osteopathic Education of the AOA at 142 East Ontario Street, Chicago, IL 60611.

 

Shannon DeConda, CPC, CEMA, CEMC, CPMA, CRTT

Ms. Shannon DeConda has been in the healthcare industry for over 20 years. Ms. DeConda founded the National Alliance of Medical Auditing Specialists (NAMAS) 16 years ago while working as a senior auditor for its parent organization DoctorsManagement. She is the President of NAMAS, a division of DoctorsManagement in which she is a partner. NAMAS was the first organization to educate and certify auditors formally. NAMAS is committed to training medical auditors and investigators. They're also committed to the continued education of those auditors and investigators in the industry by ensuring that myths and legends about the rules and guidelines are separated from the facts. Ms. Deconda's pursuit is to standardize processes and efforts with investigations and audits.

Ms. DeConda has a wide range of experience ranging from working in a physician practice, providing healthcare as a respiratory therapist, working as a biller & coder, and now providing medical audit investigations and educating others in this process. She is dually certified as a Coder and Auditor.

Ms. DeConda currently resides in Florida, and their Corporate office is in Knoxville, Tennessee. She has been married to her husband Chris for 12 years, and they have three adult children, Spencer - 26, Shakia - 25, and Sarah - 24. She also raises fur babies consisting of the canine breed Noodle, Goose, and Flo, and one feline - Max.

Ms. DeConda discloses that she has no relevant financial relationships with any organization producing, marketing, reselling, or distributing healthcare goods or services consumed by, or used on, patients relative to the content of this presentation.


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