2026 Impact - W88 - Right From the Start: Ending Denials With Data - On Demand

Healthcare denials are higher today than ever before. As health systems struggle to keep up with increasing denials, payers are also getting smarter with their scrubbers when it comes to denying claims. Statistics show that on average, 15% of all initial claims are denied, with 54% of those being overturned with appeals. Rather than focusing solely on downstream appeals, our health system shifted its strategy upstream to proactively prevent denials before claims are submitted. This project highlights how Intermountain Health leveraged enterprise data and analytics to identify denial risk early and intervene prior to billing. We present three targeted tactics that together, have protected tens of millions of dollars in revenue by reducing avoidable rework and initial denials. 

 

Handouts
 
Click here to access and download the handouts:  https://www.vizientinc.com/Learning-center/summit 
 
 

Target Audience

  • Dietitians
  • Healthcare Quality Professionals
  • Nurses
  • Pharmacists
  • Pharmacy Technicians
  • Physicians
  • Physician Associates
  • Other Healthcare Professionals

Learning Objectives

 

At the conclusion of this activity, participants should be able to:  

  • Describe how retrospective analysis of 835 and 837 claims data can be used to identify high-impact denial drivers and inform upstream process improvements to reduce initial claim denials. 
  • Explain how predictive analytics and artificial intelligence-driven workflows can be integrated into concurrent coding and clinical documentation improvement processes to proactively identify high-risk claims and improve first-pass payment rates. 
 
 

 

Course summary

Available credit: 
  • 0.50 AAPA CME
    Vizient Inc. has been authorized by the American Academy of Physician Associates (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria.
  • 0.50 ACPE Pharmacist
  • 0.50 ACPE Pharmacy Technician
  • 0.50 AMA PRA Category 1 Credit™
  • 0.50 ANCC
  • 0.50 CDR
  • 0.50 CPHQ – Certified Professional Healthcare Quality
  • 0.05 IACET
Course opens: 
10/06/2026
Course expires: 
10/06/2027
FACULTY & PLANNERS
Faculty

Sathya Vijayakumar, MS, MBA, LSSGB, Director, Physician Advisor Services, Intermountain Health, Salt Lake City, UT 

Kearstin Jorgenson, MS, CPC, COC, CIC, CCS, AVP, Physician Advisor Services, Intermountain Health, Salt Lake City, UT 

 
Planners
Juli Hermanson, MPH, RDN, CPHQ 
Course Director
AVP, Client Education 
Vizient, Inc. 
 
Adrianne Ainsworth, MBA
VP, Member Networks
Vizient, Inc. 
 
Julie Cerese
SVP, Performance Management & National Networks
Vizient, Inc. 
 
Donna Colby, RN, BSN, CMRP, CVAHP, FAHRMM, LHRM
Consulting Director
Vizient, Inc. 
 
Sydnee Cruz, MBA
Sr. Education Program Manger
Vizient, Inc. 
 
Katie Davis, DNP, MS-HSM, RN
Senior Intelligence Director, Member Networks
Vizient, Inc. 
 
Mital Desai, PharmD
Member Networks Director
Vizient, Inc. 
 
Cheryl Jachna, BS 
Education Programs Director
Vizient, Inc. 
 
Marilu Kelly, MSN, RN, NPD-BC, CHCP 
Director, Continuing Education 
Vizient, Inc. 
 
David Levine, MD 
SVP & Chief Medical Officer 
Vizient, Inc. 
 
Lindsay Mayer, RN, MSN, CPHQ
Sr Dir, Programs
Vizient, Inc. 
 
Barbara Seymour, DNP, RN, NE-BC
VP, Member Networks
Vizient, Inc. 
 
Kristen Sinke
VP, Implementation Services
Vizient, Inc. 
 
Laural Whitmore, MSE
SVP, Networks: Performance Improvement Programs
Vizient Inc.
 
 
DISCLOSURE
As an accredited provider of continuing education, Vizient, Inc. is dedicated to ensuring this activity presents learners with only accurate, balanced, scientifically justified recommendations, and is free from promotion, marketing, and commercial bias. In accordance with The Standards for Integrity and Independence in Accredited Continuing Education, all planners, faculty, and others in control of the educational content have disclosed the absence or existence of all financial relationships (of any dollar amount) with ineligible companies within the past 24 months.
 
Ineligible companies – those companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.
 
It is Vizient’s policy that owners and employees of ineligible companies, and any individuals who refuse to disclose the absence or existence of financial relationships with any ineligible companies are disqualified from participating as planners or faculty.
 
Statement of Content Validity
 
Vizient, Inc. educational activities are intended to assist healthcare teams advance their professional responsibilities in accordance with the definition of continuing education. It is the policy of Vizient, Inc. to review and ensure that all content and recommendations for patient care within accredited CE is evidenced-based, based on current science and clinical reasoning while ensuring the content is fair and balanced. All recommendations must conform to the generally accepted standards of experimental design, data collection, analysis, and interpretation. Vizient, Inc. does not permit accredited continuing education if it advocates for unscientific approaches to diagnosis or therapy, or if the education promotes recommendations, treatment, or manners of practicing healthcare that are determined to have risks or dangers that outweigh the benefits or are known to be ineffective in the treatment of patients.
 
FDA Off-Label Use
 
Faculty presenters are also expected to disclose any discussion of (1) off-label or investigational uses of FDA approved commercial products or devices or (2) products or devices not yet approved in the United States.
 
Disclaimer
The education provided through this activity is for continuing education purposes only. The views and opinions expressed in this activity are those of the faculty/presenters and do not necessarily reflect the views of Vizient, Inc.
 
Disclosure Statements
Absence of Relevant Financial Relationships
 
None of the planners, faculty, or others in a position to control content for this educational activity have relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products used by or on patients.

 

 

 

 
Joint Accreditation Statement
In support of improving patient care, Vizient, Inc. is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.
 
 
Designation Statement(s)
Interprofessional Continuing Education (IPCE)
This activity was planned by, and for, the healthcare team, and learners will receive 0.50 Interprofessional Continuing Education (IPCE) credits for learning and change.
 
Registered Dietitians/Dietetic Technicians (CDR)
The Commission on Dietetic Registration (CDR) accepts nutrition-and-dietetics-related continuing education credits from Jointly Accredited Providers. After completing this activity, CDR-credentialed practitioners may claim CPEUS under Activity Type 102; 1 contact hour (60 minutes) = 1 CPEU. 
 
Nurses (CNE)
This activity is designated for 0.50 contact hours.
 
Pharmacists (CPE)
Vizient, Inc. designates this enduring material for a maximum of 0.50 contact hours for pharmacists.
 
Universal Activity Number: JA0006103-0000-26-250-H04-P
 
Pharmacy Technicians (CPE)
Vizient, Inc. designates this enduring material for a maximum of 0.50 contact hours for pharmacy technicians.
 
Universal Activity Number: JA0006103-0000-26-250-H04-T
 
Physicians (CME)
Vizient, Inc. designates this enduring material for a maximum of 0.50 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
 
Physician Associates (AAPA)
Vizient, Inc. has been authorized by the American Academy of Physician Associates (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 0.50 AAPA Category 1 CME credits. Approval is valid until October 7, 2027. PAs should only claim credit commensurate with the extent of their participation. 
 
Healthcare Quality Professionals (CPHQ)
This activity is approved by NAHQ® for 0.50 CPHQ CE credits.
 
Other Healthcare Professionals (IACET)
Vizient, Inc. is Jointly Accredited by the Joint Accreditation for Interprofessional Continuing Education and has been approved to offer Continuing Education Units (CEUs). CEUs are awarded for learning events that align with the ANSI/IACET Standard for Continuing Education and Training. IACET is recognized internationally as a standards development organization and accrediting body that promotes quality continuing education and training. 
 
This learning event is eligible for 0.05 Continuing Education Units (CEUs). 
 
 

Available Credit

  • 0.50 AAPA CME
    Vizient Inc. has been authorized by the American Academy of Physician Associates (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria.
  • 0.50 ACPE Pharmacist
  • 0.50 ACPE Pharmacy Technician
  • 0.50 AMA PRA Category 1 Credit™
  • 0.50 ANCC
  • 0.50 CDR
  • 0.50 CPHQ – Certified Professional Healthcare Quality
  • 0.05 IACET
Please login or register to take this course.

 

Select the Obtain Credit button to access the activity.
 
Please Note: 
  • If the Register/Take Course tab is displayed instead of the Obtain Credit tab, you must first login to proceed with the credit claim process.

Required Hardware/software

The Vizient CE Learner Portal is compatible with most modern web browsers (such as Firefox, Google Chrome, Microsoft Edge, Apple Safari) and can also be accessed with mobile devices.