Panels and Presentations Addressing Key Challenges of Revenue Cycle Management 

Panels and Presentations Addressing Key Challenges of Payment Integrity

Payer-provider abrasion remains one of the biggest barriers to efficient payment, timely care, and operational success. Too often, denials, delayed payments, and prior authorization disputes stem from misaligned expectations, incomplete data, and unclear communication—not true disagreement. This session will offer a candid, solutions-focused discussion on what payers really need from providers, what providers can do upfront to reduce friction, and how both sides can work together to minimize rework, prevent avoidable denials, and create shared wins.

Learning Objectives:

• Gain clear insights into how providers can proactively align documentation, coding, and authorization workflows to meet payer requirements and reduce denials and appeals.
• Learn practical approaches to improve data sharing, reduce ambiguity in clinical and billing documentation, and foster payer-provider partnerships that lead to faster resolutions and fewer administrative burdens.
• Explore strategies to move beyond transactional interactions and build trust-based partnerships between payers and providers—focusing on shared goals like timely care, accurate payment, and operational efficiency.

Denial management isn’t just about fighting back—it’s about understanding why denials happen and fixing the root causes upstream. This session will focus on how hospitals and health systems can use audit findings and denial data to identify coding gaps, documentation weaknesses, and process breakdowns that lead to preventable denials. Learn how to close these gaps through stronger internal collaboration across revenue cycle, coding, and clinical teams, while also using data-driven insights to foster more productive payer relationships.

Learning Objectives:

• Learn how to analyze denial patterns and audit results to uncover documentation, coding, and process issues—enabling proactive prevention rather than reactive rework.
• Discover best practices for improving internal workflows, fostering collaboration between clinical and revenue cycle teams, and ensuring that claims reflect accurate, defensible coding and clear clinical intent.

As value-based care continues to reshape payment models, many health systems struggle to balance financial performance with care quality goals. This session will offer practical strategies to use denial data, coding insights, and care coordination metrics to strengthen value-based outcomes—without sacrificing revenue. This discussion will highlight how to engage teams, optimize processes, and identify sustainable financial opportunities within value-based contracts.

Learning Objectives:

• Learn how to use denial patterns and audit insights to improve documentation, coding accuracy, and contract performance.
• Gain strategies to foster physician buy-in and leadership collaboration, finding “win-win” solutions that support both revenue integrity and value-based care success.