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[In-Person] Billing & Reimbursement Seminar: Forensic Denials DME 2024 – Season 3: Episode 1

Event Details

Date Thursday, February 8, 2024
Time 8:30am - 12:30pm
Location DoubleTree by Hilton Tampa Rocky Point Waterfront
3050 North Rocky Point Drive West
Tampa, FL 33607
see map

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

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, audit, etc.). 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, including:

  • Identifying the motive of the contractors when implementing medical policies into prior authorization and processing guidelines.
  • Learning how to conduct a detailed analysis of the evidence (denial), 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.

We’ve recruited Kim Cuce, who is now with VGM, to assist with the investigations.

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


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