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Impact of Payer Denial Tactics on the Clinical Revenue Cycle

Thursday, January 25, 2024
11:00 am12:00 pm

Many Medicare Advantage payers run a for-profit business model, and any dollar they can avoid paying providers for care is a dollar they can count toward their profits. In this zero-sum game, your hospital’s revenue integrity strategy needs to evolve at the same velocity as the payers’ payment mitigation strategy. Join us as we discuss payers' tactics related to DRG integrity, denials and appeals. We’ll explore strategic interventions that are data driven to combat these tactics.

Attendees Will Learn:

The macro-Payer/Provider dynamics in the market and the tactics payers employ on hospitals to maximize their profits.
The mechanisms to develop a data-driven approach to identify/quantify the impact payer tactics are having on their organizations and strategies (both internal process-driven and external payer escalation initiatives) to hold payers accountable for appropriate reimbursement.

Speakers:

Jerilyn P Morrissey, MD
Chief Medical Officer
CorroHealth

Samuel Dominik
Managing Director, Strategic Advisory Services
CorroHealth