Audit claim rejection analysis in practice, not only in policy.
Analysing Medical Claim Rejections and Reducing Their Rates
Turn claim rejection analysis from a stated policy into a practice your organisation can evidence.
📍 Tunis🗓️ 5 training days📚 4 modules🎓 Accredited certificate
5intensive training days
4scientific modules
8training sessions
32detailed points
Course Overview
Clinical staff will work around a process for claim rejection analysis that obstructs care, and they will be right to. The data supporting this area of health and pharmaceutical services is usually present but rarely assembled into a decision. The professional literature on this aspect of health and pharmaceutical services converges on a small set of controls that reliably work. Participants finish able to explain claim rejection analysis to a non-specialist audience without losing precision. It is appropriate for those preparing to take on wider responsibility for the wider health and pharmaceutical services agenda. Participants test their assumptions about the health and pharmaceutical services discipline against scenarios designed to break weak ones. The programme is built to be used, and every section of claim rejection analysis it covers ends in something applicable. What blocks progress on this aspect of health and pharmaceutical services is usually unclear ownership rather than unclear intent. The programme ends where implementation begins, with the health and pharmaceutical services capability broken into steps someone can start on Monday.
Expected Learning Outcomes
Align claim rejection analysis with the wider objectives of the clinical service rather than optimising it in isolation.
Control cost per episode within claim rejection analysis without shifting risk to patients.
Plan continuity of claim rejection analysis during surge, outbreak and emergency.
Assess and control infection risk associated with claim rejection analysis.
Translate policy on claim rejection analysis into procedures that hold up under day-to-day pressure.
Distinguish the parts of claim rejection analysis that must be standardised from those that require judgement.
Who Should Attend
Regulatory affairs specialists handling claim rejection analysis.
Supply chain and biomedical staff supporting claim rejection analysis.
Finance managers costing services delivered through claim rejection analysis.
Hospital and health facility managers accountable for claim rejection analysis.
Analysts producing the data on which decisions about claim rejection analysis rest.
Project and programme managers whose delivery depends on claim rejection analysis.
Course Modules
Claim rejection analysis: clinical process design and workflow
2 sessions · 8 pointsSession 1Auditing claim rejection analysis at the bedside, not in the binder
- Identify where judgement in claim rejection analysis is legitimate and where it is not.
- Plan continuity of claim rejection analysis during surge and outbreak conditions.
- Build the internal briefing that explains claim rejection analysis to those affected.
- Build the competence framework that supports claim rejection analysis.
Session 2The hard cases in claim rejection analysis and how to reason about them
- Audit claim rejection analysis by observing practice, not by reading policy.
- Check that consent processes within claim rejection analysis are genuinely informed.
- Build medication safety checks into claim rejection analysis at the point of highest risk.
- Identify infection transmission risks created by claim rejection analysis and control them.
Claim rejection analysis: supply, cold chain and availability
2 sessions · 8 pointsSession 1The evidence assessors will ask for on claim rejection analysis
- Define escalation criteria for deterioration detected through claim rejection analysis.
- Assemble the accreditation evidence pack for claim rejection analysis.
- Agree what will be standardised in claim rejection analysis and what will not.
- Anticipate the objections claim rejection analysis will raise and prepare the answers.
Session 2Consent, confidentiality and ethics in claim rejection analysis
- Apply structured root cause analysis to the last adverse event involving claim rejection analysis.
- Confirm patient data handled within claim rejection analysis meets confidentiality obligations.
- Map the clinical workflow for claim rejection analysis as it is actually performed.
- Establish who is informed, consulted and accountable in claim rejection analysis.
Claim rejection analysis: medication and treatment safety
2 sessions · 8 pointsSession 1Making incident reporting on claim rejection analysis safe for staff
- Confirm licensing and regulatory requirements applying to claim rejection analysis are met.
- Plan the sequence in which improvements to claim rejection analysis will be introduced.
- Rehearse the briefing on claim rejection analysis that would follow an incident.
- Select quality indicators for claim rejection analysis that measure outcome rather than activity.
Session 2Designing claim rejection analysis so it helps rather than obstructs care
- Set the review interval for claim rejection analysis and who attends.
- Set escalation thresholds for claim rejection analysis that work out of hours.
- Reduce unwarranted variation in claim rejection analysis between shifts and sites.
- Confirm competence and continuing development for staff delivering claim rejection analysis.
Claim rejection analysis: confidentiality, consent and ethics
2 sessions · 8 pointsSession 1Who answers for claim rejection analysis, and to whom
- Cost claim rejection analysis per episode and identify avoidable waste.
- Reduce the variation in how claim rejection analysis is carried out between teams.
- Confirm the incident reporting route for claim rejection analysis is quick and non-punitive.
- Estimate the resource claim rejection analysis requires to run as designed.
Session 2Getting other functions to support claim rejection analysis
- Decide what will be stopped to create capacity for claim rejection analysis.
- Confirm that contractual obligations around claim rejection analysis are understood.
- Map the handovers in claim rejection analysis between functions and secure them.
- Close out actions on claim rejection analysis rather than leaving them open indefinitely.
Choose the package that suits you
Silver Package
At least 3 people
USD1,250
- Workshop or Program Participation
- Airport Transfers
- Customized Badge
- Expert Mentorship (Private Sessions)
- Supervision & Secretarial Services
- Accredited Certificate of Participation
- Complete Training Kit
- Coffee Break
- Closing Ceremony
Gold Package
At least 3 people
USD1,850
- 5-night stay in a 5-star hotel
- Workshop or Program Participation
- Airport Transfers
- Customized Badge
- Expert Mentorship (Private Sessions)
- Supervision & Secretarial Services
- Accredited Certificate of Participation
- Complete Training Kit
- Coffee Break
- Closing Ceremony
Complete your registration
We will contact you within one business day to confirm.