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

Published in Complex Rehab on April 26, 2022

Medtrade 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