AppealLettersOnline.com eNewsletter: Reimbursement eNewsletter for the healthcare community
Denial Analysis Often Improves Healthcare Profitability
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, often uncharted, sea of denial data being generated in the initial stages of healthcare denial management.  Read this entire article for information on implementing effective denial analysis within your organization.
 
Featured Appeal Letters
The AppealLettersOnline.com Repository has numerous state-specific letters to assist with interest collection.  These letters directly quote state standards which require certain insurance plans to pay interest on claims not paid within that state’s required prompt pay time frame.....sign up for access the appeal letter repository
 
New Letter to Assist With Global Billing Appeals
We have a number of physician clients who are reporting problems getting insurance carriers to pay for treatment outside of global reimbursement restrictions. Appeal Solutions has drafted an appeal letter to assist medical practices with these appeals. See the new letter under the category “Benefit Reductions,” subcategory “Miscellaneous,” titled Global Services Reductions.
 

Specialty Highlight: The U.S. District Court has just issued a very favorable ruling related to insurance carriers attempting to obtain medical records from DME suppliers who have already submitted a CMN to substantiate medical necessity. Read this entire article...