Denied to Approved: Real-World Hacks for Rural Hospitals

Course Description

Rural and critical access hospitals face unique challenges when navigating medical claim denials from Medicare inpatient downgrades to missing documentation and timely filing errors. With limited staff, and tight budgets, these hospitals need actionable strategies to stop revenue loss in its tracks.

This live 1-hour webinar dives into the top denial types affecting small hospitals and explores real-world solutions you can implement immediately even without fancy software or a full appeal team.

Learn how your utilization review (UR) department can play a critical frontline role in preventing denials before they happen. We’ll break down how proactive, interdisciplinary UR efforts such as early inpatient reviews, standardized documentation checks, and leveraging the 2-Midnight Rule can reduce audit risk and minimize denials from occurring in the first place.

You’ll walk away with free templates, and proven hacks for writing powerful appeal letters, tracking denials manually. We’ll also share how small teams can use weekly huddles, denial dashboards, and collaborative toolkits to turn denials into dollars. If you’re ready to fight smarter, not harder, this webinar is built for you.

Learning Objectives

• Identify the top types of medical claim denials affecting rural and critical access hospitals and explain how these differ from denials in larger healthcare systems.
• Recognize common operational barriers that rural hospitals face in managing denials and appeals, including staffing, training, and technology limitations.
• Apply low-cost, high-impact strategies to track, analyze, and respond to denials using limited resources, including templates, team-based approaches, and manual tracking tools.
• Construct stronger appeal letters especially for inpatient downgrades to observation—using clinical language, regulatory criteria, and Medicare policy references.
• Describe how the utilization review department can proactively identify and intervene in high-risk cases to prevent common Medicare denials.
• Demonstrate how interdisciplinary communication between case management, billing, and clinical teams—can reduce denial risks and support successful appeals.
• Explain how standardized documentation and pre-certification processes can improve claim accuracy and reduce preventable denials.

Areas Covered in the Session

• Types of Denials Seen in Rural & CAHs
• Reactive vs. proactive denial strategy
• Prevention is as important as appeal writing
• Understand the 2-Midnight Rule thoroughly
• Standardize pre-cert and documentation processes
• Communication gaps between departments (case management, billing, clinical)
• 1 in 5 Americans rely on rural hospitals
• Live Q&A Session

Suggested Attendees

• Case Managers
• Health Information Managers
• Revenue Cycle Leaders
• Utilization Review
• Physician Advisors
• Finance leaders
• Billing
• Billing Specialists
• Compliance Officers
• Clinical Documentation Improvement (CDI) Specialists
• Hospital Administrators
• Quality Improvement Staff
• Medical Records Professionals
• Prior Authorization and Pre-certification Staff
• Audit and Appeals Coordinators
• Rural Health Clinic Managers
• Payer Relations Representatives
• Denials Management Teams

About the Presenter

Karen A. Bartrom, MSN, RN, CCM is an experienced Nurse Case Manager leader who has worked in rural and critical access hospitals since 2006. Her work has focused on patient advocacy and securing appropriate reimbursement for hospital services by developing effective strategies to manage denials and write successful appeals. Over time, she has built strong partnerships with Revenue Cycle teams, working collaboratively to align clinical care with financial goals.

These partnerships have led to proactive workflows that support timely reviews, accurate documentation, and improved reimbursement outcomes. She emphasizes the critical role of clear, accurate clinical documentation in building strong appeals, ensuring medical necessity is well-supported and clearly understood by payers.

Through her dedication, expertise, and collaborative approach, Karen continues to strengthen case management practices that protect both patient care and the financial health of rural hospitals.

Additional Information:

After Registration: You will receive an email with login information and handouts (presentation slides) that you can print and share with all participants at your location.

System Requirement:

• Internet Speed: Preferably above 1 MBPS
• Headset: Any decent headset and microphone which can be used to talk and hear clearly

Live Course Cancellation Policy: If for any reason Skillacquire need to cancel this program, Skillacquire will notify participants by email of the cancellation no less than 24 hours prior to the expected start time.

Can’t Listen Live?

No problem. You can get access to an On-Demand webinar. Use it as a training tool at your convenience. For more information, you can reach out to the below contact:

Toll-Free No: 1-302-444-0162

Email: care@skillacquire.com

Address:- 651 N. Broad Street, Suite 206, Middletown, DE 19709

Testimonials:

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Sandie Fowler, Out of Network Billing Staff"Great presentation. Able to do during the day. Timing was great"

Tina Duffy, Compliance Officer

All tickets include recording of the event.