In this two part series, providers will be presented with best practices associated with successful denial management programs. Providers will also gain a deeper understanding of how to use ERISA information in conducting appeals. Provider Denial Management - assessing processes and avoiding program failure

Insurance carriers increasingly cite ERISA law when denying medical claims. In fact, ERISA gives employee health benefits plans wide discretion over what medical benefits to provide and how lucrative the benefits are. Are providers' hands tied when it comes to low payments and outright denials related to ERISA? Absolutely not. ERISA contains a number of protections favorable to the provider who understands ERISA law and how to use it to secure the right to full and fair review of denials. Our speaker will discuss how to use ERISA law to draft successful medical claims appeals. Appeal tactics will be discussed which assist providers highlight contract payor performance in the area of denials, underpayments and appeals.