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Samples of our resources.
SLIDESHOW: 5 Sentences to Improve Your Appeal Letters|
Do your carefully worded appeals result in simple form letter responses? If so, it is likely that your appeals may need more forceful language regarding carrier appeal review and response requirements. Getting the insurance carrier to provide a customized detailed response starts with making appeal letters more specific in regard to the appeal review and response requirements. . . . download >>
Seven Tips To A Successful Medical Necessity Appeal
AppealLettersOnline.com has a number of letters citing state and federal disclosure laws which assist medical providers with demanding more complete information regarding denials. These letters are under the. . . .more >>
Denial Analysis Tactics to Improve Reimbursement
What gets studied gets improved. This is one of the simplest management concepts yet one of the most challenging when it comes to ambiguous data. What is understood gets improved is the more accurate maxim for analyzing the ambiguous. . . .more >>
Another Day in the Paradise of Managed Care Reimbursement
It has happened again... another reimbursement check and Explanation of Benefits (EOB) has arrived from a Managed Care Organization (MCO) with an amount less than what you believe is due to you under your MCO agreement. What do you do now. . . .more >>
|Who's Reviewing Your Appeals? Man or Machine?|
Appeals involve highly technical issues such as clinical guidelines, specialty coding standards, quality of care and contract requirements. It takes a highly qualified appeal reviewer to respond appropriately. However, carrier appeal responses fall short again and again. . . .more >>
|Hospital Replaces Rebills With Appeals|
CASE STUDY: Rebilling unpaid claims at 60 to 90 days has long been a rule of thumb in medical receivables management. However, a California hospital has found a much more appealing method of handling aged claims that resulted in an immediate drop in aged accounts. . . .more >>
|Insurance Recovery Requires Attitude|
In appealing denied insurance claims, you need to have the mindset that it is the insurance carrier's burden to prove that the claim has been processed correctly and that any ambiguities in the coverage terms. . . .more >>
|Successful Denial Management Requires 2 Appeals|
Most denials require two appeals for two reasons: first, insurance carriers do not always provide credentialed professionals for the initial review and second, insurance carriers often provide details in the Level I appeal response which may require further discussion. . . .more >>
|A Day Late and a Dollar Short|
Your business office missed the timely filing deadline by 30 days. The claim is filed and comes back denied. Now you have to make a decision - pursue the patient, write-off or appeal. . . .more >>
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