AHC Helps Hospitals Resolve Discounted Insurance Payments

Share Article

For nearly fifteen years, AHC Healthcare Receivables Management has been providing accounts receivable management solutions and healthcare reimbursement educational offerings to help hospitals maximize reimbursement. At the recent Healthcare Financial Management Association (HFMA) Tri-State Institute, AHC provided education on how providers can successfully resolve "usual and customary" denials.

An increasingly common and often confusing tactic used by payers is the act of applying "usual and customary" discounts to healthcare claims, leaving the balance to be either written off or placed as a burden on the patient. Shirley Dawson, Senior Research Attorney for AHC Healthcare Receivables Management recently discussed how the healthcare community can utilize a payer-specific approach and resolve these claim reduction issues. Her seminar, "Managing Usual and Customary Denials: A Legal Perspective", was presented at the HFMA Tri-State Institute in Tunica Resorts, Mississippi on January 18. The conference was attended by over 200 of the healthcare industry's top financial experts from Arkansas, Tennessee, and Mississippi.

Representative provider organizations in attendance included:

Baptist Memorial Health Care

DeTar Healthcare System

Forrest General Hospital

Memorial Gulfport

Methodist Healthcare

St. Jude Children's Research Hospital

St. Vincent Health System

UAB Health System

....and many others

Session attendees received education on the various tactics employed by payers, state statutes, federal regulations, case law, correct guidelines utilized in determining "reasonableness" of charges for each payer type, and appropriateness of patient involvement in each payer situation.

Having completed over 230 educational seminars in 2006, AHC continues their commitment to the healthcare community by providing complimentary, on-site healthcare reimbursement education. Interested parties who wish to learn more or schedule a complimentary workshop for their hospital business office staff, may contact AHC at (888) 511-7901 or visit http://www.ahcinc.com.

About AHC:

AHC Healthcare Receivables Management (http://www.ahcinc.com) provides technology enabled accounts receivables management solutions and complimentary education offerings for the healthcare community. Employing over 500 healthcare reimbursement professionals, approximately 100 of which are attorneys, AHC utilizes federal and state regulations, established case law, and client specific protocols to provide guaranteed results to our 760 clients nationwide. AHC has offices in Virginia, New York, Florida, Illinois, and California

About Shirley Dawson:

Shirley M. Dawson is a Senior Research Attorney in AHC's Client Management Department. Before becoming a Senior Research Attorney, Ms. Dawson worked high dollar claims for a priority client in her role as Staff Attorney in AHC's Problem Claims Department. In addition to conducting health insurance reimbursement workshops for AHC's clients nationwide, Ms. Dawson plays an active role as a member of AHC's team of attorneys dedicated to legal research. Ms. Dawson tracks changes in state and federal laws that impact the healthcare industry and researches legal and regulatory questions posed by AHC's clients.

Ms. Dawson graduated magna cum laude from North Carolina Central University with a Bachelor of Arts Degree in Political Science and received her Juris Doctorate from Cleveland State University‑Cleveland Marshall College of Law.

# # #

Share article on social media or email:

View article via:

Pdf Print