As Director of Denials Management for Wound Care Advantage, Vanessa Ploessel works with WCA partners to identify root causes and implement effective processes to not only reduce the number of claim denials, but also to prevent them from occurring in the first place.
Q: Tell us what sparked your initial interest in healthcare.
A: I’ve always been interested in healthcare. For as long as I can remember, I knew I wanted to be a part of it. I wanted to find a way to make a difference and help others.
Q: Tell us about your job as it relates to denials and revenue cycle management.
A: We work with wound care and hyperbaric centers throughout the nation, primarily with outpatient hospital clinics. The denials management team takes a very close look at coding and billing, as well as revenue cycle. We’re always looking at whether or not there’s a process that can be improved, and whether proper coding and billing procedures are taking place. If not, we want to figure out how can we help, and how we can educate.
Q: How do you help your partners keep up with continuous changes in regulations and laws?
A: This is one of the places where we can really offer our expertise and keep our partners up to date on new regulations. Whether they’re state or federal, we monitor changes and educate outpatient wound care teams on how the changes are going to affect their center, or let them know what they need to prepare for.
Q: What do existing wound care programs need the most?
A: We’ve had many self-managed centers come to us for help because they’re busy focusing on patients. They don’t have a lot of time to look at the numbers, or review denials, and figure out how they can improve their processes. They need help and support, and that’s where we come in.
Q: What is your team’s ultimate goal?
A: We’re here to help outpatient wound care and hyperbaric oxygen therapy centers improve financial operations and efficiency while continuing to make patient care a top priority. That’s our goal.