The decision to appeal or accept a RAC denial is an important one for healthcare providers. As Kenny Rogers once sang “You got to know when to hold 'em, know when to fold 'em” and the same can be said about appealing RAC denials. Appealing RAC denials is a complex process and trying to overturn a denial beyond the second level of appeal can be a costly endeavor if unsuccessful; however, healthcare providers can take certain steps to increase their success rate.

Knowing when to appeal or not to appeal is crucial and can be the difference between recouping your legitimate revenue or compounding your loss. Join us for a free webcast with leading RAC authority, Day Egusquiza, as she provides sound guidance based on her most recent experience helping a wide variety of healthcare providers, both large and small. In her presentation, Day will cover:

• Preventing the need for the appeals process by identifying hot spots for audits that may result in denied claims.
• Each step of RAC claims review/appeal process including critical deadlines & data requirements.
• Using deadline dates for your benefit by forcing the RAC Auditor to comply with CMS guidelines.
• Advance preparation and operational approaches for conducting your own internal risk assessments.
• A review of Transmittal 141, CR 6183 published on 9-12-08; “Limitation on recoupment/935”

Who Should Attend:

• Hospitals
• Physicians and their staffs
• CFO, CEO
• Chief Compliance Officer
• Compliance Director
• Chief Risk Officer
• Director of Risk Management
• Director of Regulatory Affairs
• Hospital Legal/Regulatory Counsel
• VP/Director of Revenue Cycle

About the Presenter:

Day Egusquiza brings over 28 years experience in health care reimbursement, hospital business office operations, contracting and compliance implementation. Additionally, her experience includes eight years as a Director of a Physician Medical Management billing service and most recently completed an integrated business office between a hospital and a large physician clinic. She has been an entrepreneur in hospital and physician practice accounts receivable management and a leader in redesigning numerous organizations. Her work includes providing guidance as a compliance and APC educator while providing operational insight on the revenue cycle impacts of HIPAA. Additionally, she has been instrumental in researching and preparing national education on the impact of the Prescription Drug Benefit to hospitals and nursing homes. Ms. Egusquiza is a nationally recognized speaker on continuous quality improvement (CQI), benchmarking, redesigning, reimbursement systems and implementing an operational focus of compliance- both in hospitals and practices. She has been on the AAHAM National Advisory Council, HFMA National Advisory Council, HFMA faculty, CCH Reimbursement Advisory board and is a past President of the Idaho HFMA Chapter &; recently received the Lifetime Achievement Award. She has been highlighted in JCAHO's Six Hospitals in Search of Excellence, Zimmerman's Receivable Report, HFMA's HFM and Patient Account, AHIA Prospective, and numerous healthcare newsletters along with a contributing author to 2006 Health Law and Compliance Update. She received the Idaho Hospital Association Distinguished Service Award; for her legislative work and training on new indigent law. Attendees at HFMA's ANI rated her in the top 25%, earning her the 'Distinguished' Speaker recognition for each year she has presented.