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Clinical Validity Denial Defense: Tactics and Tips to Tackle the Issues

Product Code: YHHA121322A

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Clinical Validity Denial Defense: Tactics and Tips to Tackle the Issues

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Presented on: Tuesday, December 13, 2022 | 1:00–2:00 p.m. Eastern

Presented by: Stacy Reck, MBA, RHIA, CDIP, and Ashley Wells, MN, CMSRN, RN, CCDS

The number 1 defensive strategy for clinical validity denials is to understand what’s happening at your facility. In this 60-minute webinar, Stacy Reck, MBA, RHIA, CDIP, director of CDI/utilization review at Avera Health in Sioux Falls, South Dakota, and Ashley Wells, MN, RN, CMSRN, CCDS, CDI specialist III at Methodist Health in Dallas, Texas, will share the strategies that work for their organization as they tackle clinical validity denials. 

The webinar will cover the difference between clinical validity and coding-related denials, as well as the importance of being aware of the volumes of denials and their possible financial impact on the organization. Reck and Wells will detail the methods they use to track, trend, and defend, including education for CDI staff, coding, and even providers.

The presentation will conclude with a live Q&A during which attendees can submit questions.

At the conclusion of this program, participants will be able to: 

  • Define how clinical validity denials impact healthcare organizations
  • Describe the ways Avera Health and Methodist Health track and trend their denials
  • Discuss three strategies for defending against clinical validity denials

Agenda

  • Definition of clinical validity denials
  • Are you tackling clinical validity denials?
  • Key steps in managing these denials
    • Track, trend, and defend
  • Tracking and trending diagnoses
  • Defensive strategies
    • Develop and educate staff
    • Trend your organization’s denials
    • Notice patterns and identify deficiencies

Who Should Listen?

  • CDI directors and managers
  • CDI staff
  • HIM/coding directors and managers
  • Coding staff
  • Revenue integrity directors and managers
  • Revenue integrity staff
  • Denials and appeals staff CDI staff

Meet the Speakers

Stacy Reck, MBA, RHIA, CDIP, is the director of CDI and utilization review (UR) at Avera Health in Sioux Falls, South Dakota. She is responsible for strategic and operational planning, design, implementation, and oversight of systemwide standardization of CDI and UR programs. She has 19 years of experience in inpatient and outpatient coding, denials management, daily accounts receivable operations, chargemaster maintenance, CDI, and UR. Reck has served as president and director of education for the South Dakota Health Information Management Association board. She has presented at national conferences on topics including ICD-10 and CDI.

Ashley Wells, MN, CMSRN, RN, CCDS, is a CDI specialist III at Methodist Health System in Dallas, Texas. She has nine years of nursing experience. After three years juggling her bedside role, graduate studies, adjunct nursing, and voluntary work for several nursing associations near Portland, Oregon, she relocated to Texas and took a nurse educator role. Three years ago, Wells applied for a CDI position at her current organization and fell in love with the profession. In this role, she has worked on educational efforts for providers and staff, completed interdisciplinary projects related to quality metrics, and obtained her CCDS. Recently, she also took on the clinical validation appeals role for her department.

Continuing Education

ANCC
HCPro is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation. 1 contact hours for nurses are available for this activity.

Ability to claim credits for this webinar expires on: 12/12/2023

ACDIS
This program has been approved for 1 continuing education units towards fulfilling the requirements of the Certified Clinical Documentation Specialist (CCDS) certification and CCDS-O (outpatient) certification, offered as a service of the Association of Clinical Documentation Integrity Specialists (ACDIS).

Ability to claim credits for this webinar expires on: 12/12/2023

AHIMA
This program has been approved for continuing education unit(s) (CEUs) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting of Approved CEUs from AHIMA does not constitute endorsement of the program content or its program provider.

Ability to claim credits for this webinar expires on: 12/12/2023| 

NAHRI
This program has been approved for 1 continuing education units towards fulfilling the requirements of the Certification in Healthcare Revenue Integrity (CHRI), offered as a service of the National Association of Healthcare Revenue Integrity (NAHRI).

Ability to claim credits for this webinar expires on: 12/12/2023

Instructions

Webinar system requirements and program materials: 
To fully benefit from the webinar experience, please note you will need a computer equipped with the following:

Browser: Microsoft Internet Explorer or Edge, Firefox, Chrome, or Safari, with JavaScript enabled 
Internet: Internet connection (high-speed connection recommended) 
Streaming: Access audio/video streaming from any browser on a computer, mobile, or tablet device

Prior to the webinar, you will receive an email with detailed system requirements, your login information, presentation slides, and other materials that you can print and distribute to all attendees at your location. 

CAN'T LISTEN LIVE? 
No problem. The On-Demand version will be available. Use it as a training tool at your convenience—whenever your new or existing staff need a refresher or need to understand a new concept. Play it once or dozens of times. A $229 value! 

PLEASE NOTE 
Participation in the webinar is just $229 per site. All materials must be retrieved from the Internet.

Call your customer service representative toll-free 800-650-6787 or email customerservice@hcpro.com if you have questions.