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

Tenacity, Trailblazing, & Tech: Robin Menchen's Vision for Future of HME thumbnail Tenacity, Trailblazing, & Tech: Robin Menchen's Vision for Future of HME Robin Menchen, the 2025 HME Woman of the Year, shares her advice to other aspiring leaders in the HME industry: Adopt a can-do attitude. 2025 Growth Strategies in the Complex Rehab Technology Industry thumbnail 2025 Growth Strategies in the Complex Rehab Technology Industry Forward-thinking businesses are adopting strategic approaches to fuel growth and expand impact. Here are some key strategies CRT dealers are leveraging in 2025. Trends in Wages and Costs Across Healthcare: Overview and Future Trends thumbnail Trends in Wages and Costs Across Healthcare: Overview and Future Trends In the ever-evolving landscape of healthcare, understanding the trends in wages and costs is crucial for both professionals and organizations. Unlocking a New Revenue Stream: Understanding Lymphedema Compression thumbnail Unlocking a New Revenue Stream: Understanding Lymphedema Compression Ronda Buhrmester, Senior Director of Payer Relations and Reimbursement at VGM & Associates, and Noel Neil, Chief Compliance Officer at ACU-Serve, unpack the nuances of lymphedema compression therapy. ATP Gateway Allows Repair Techs to Explore New Career thumbnail ATP Gateway Allows Repair Techs to Explore New Career U.S. Rehab added a new ATP Gateway program to the back end of its recent live tech training events in an effort to increase the funnel of ATPs entering the market by leveraging the repair tech workforce. Heartland Conference 2025 Recap: Where Innovation Meets Intention thumbnail Heartland Conference 2025 Recap: Where Innovation Meets Intention Heartland 2025 brought together a vibrant community of professionals who are not only navigating change but actively shaping the future of care. Heartland Conference 2025 Recap: Where Innovation Meets Intention thumbnail Heartland Conference 2025 Recap: Where Innovation Meets Intention Heartland 2025 brought together a vibrant community of professionals who are not only navigating change but actively shaping the future of care. The Cost of Doing Business in the Sleep Apnea Space: A Respiratory Therapist's Perspective on HME Challenges thumbnail The Cost of Doing Business in the Sleep Apnea Space: A Respiratory Therapist's Perspective on HME Challenges Discover what it costs to support a patient in the sleep apnea space and how finding a partner with a comprehensive program can help mitigate these challenges.