Heartland Sneak Peek: Forensic Denials – DME Season 2 Episode 1

Published in Member Communities on April 26, 2022

Ronda and DanMedtrade attendees raved about season 1 of Forensic Denials so much that the lead investigators are bringing season 2 to the VGM Heartland Conference in June, and with ALL new cases to solve. 

Eagle-eyed reimbursement experts Ronda Buhrmester, from VGM & Associates, and Dan Fedor, from U.S. Rehab, will review some of the most horrific claim denials as they assemble the pieces left behind to determine the culprit. They will, along with the witnesses (the attendees), re-create the scene of the claim submission and investigate each one to determine if it was an innocent error, intentional, or something even darker.

This is an interactive session where the attendees WILL participate during the investigation of some of the most hair-raising denials (claim submission, prior authorization, post-pay audit). We will uncover what went horribly wrong from the intent of the policy to that fateful day of the denial. 

You are probably asking yourself, “What will I gain from this session?”  There will be several takeaways, like identifying the motive of the contractors when implementing medical policies into prior authorization and processing guidelines. Another takeaway will be learning how to conduct a detailed analysis of the evidence (denial) and trace it back to the policy to determine what went wrong with the objective to resurrect the current denial(s) and implement procedures to reduce (eliminate) the chance of these horrible denials in the future.

If you have any unsolved cases of your own bring them to be analyzed by the forensic team (remember no PHI).

We hope to see you at the Heartland Conference for this interactive session.  Learn more and register at vgmheartland.com.


TAGS

  1. billing & reimbursement
  2. heartland

From Our Experts

A Letter From the President: June 2025 thumbnail A Letter From the President: June 2025 Lindy Tentinger shares information on the VGM Heartland Conference, competitive bidding, new tools, and more. The Latest in Billing & Reimbursement from Ronda Buhrmester: Oxygen Equipment Updates and Reminders thumbnail The Latest in Billing & Reimbursement from Ronda Buhrmester: Oxygen Equipment Updates and Reminders Ronda Buhrmester, Sr. Director of Payer Relations and Reimbursement, shares updates on oxygen equipment groups. Maximize Your Heartland Experience: Tips, Tools, & Must-Knows thumbnail Maximize Your Heartland Experience: Tips, Tools, & Must-Knows Here's everything you need to know to ensure a smooth, successful, and unforgettable Heartland experience. Maximize Your Heartland Experience: Tips, Tools, & Must-Knows thumbnail Maximize Your Heartland Experience: Tips, Tools, & Must-Knows Here's everything you need to know to ensure a smooth, successful, and unforgettable Heartland experience. 2025 O&P Woman of the Year Nominations Now Open thumbnail 2025 O&P Woman of the Year Nominations Now Open The nomination period for the 2025 O&P Woman of the Year Award is open now through July 11. This award is open to all women who work in the O&P profession. Understanding the Value of ATP Certification and ATP Academy thumbnail Understanding the Value of ATP Certification and ATP Academy Becoming an ATP is a popular path often taken by occupational therapists (OTs), physical therapists (PTs), occupational therapy assistants (OTAs), physical therapy assistants (PTAs), and wheelchair technicians. With an ATP certification, one can both fill the needs of suppliers to sell certain wheelchairs and demonstrate that they have the skills and knowledge to complete their job as defined by the leading authority in the credentialing industry. Mobility Awareness Month: Celebrating the Impact of Mobility Providers thumbnail Mobility Awareness Month: Celebrating the Impact of Mobility Providers May is Mobility Awareness Month, a time recognizing the importance of mobility solutions, the professionals who provide them, and those who rely on them. Mobility Awareness Month: Celebrating the Impact of Mobility Providers thumbnail Mobility Awareness Month: Celebrating the Impact of Mobility Providers May is Mobility Awareness Month, a time recognizing the importance of mobility solutions, the professionals who provide them, and those who rely on them.