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DENIALS & APPEALS
Discuss topics such as denials management, appeals strategies, external auditors, and more.
Discussion List
Bed Charging Policy
67
views
1
comment
0
points
Most recent by
ecutter
May 19
Responsibility for Denials Analysis
43
views
0
comments
0
points
Started by
hildebjl
February 25
MUE for CPT Code 11045
147
views
1
comment
0
points
Most recent by
slgincconsulting@aol.com
January 29
Optume Pre-Payment Denials Tips
192
views
2
comments
0
points
Most recent by
Lashunda.Murray@UTSouthwestern.edu
January 10
NDC box vs vial
268
views
1
comment
0
points
Most recent by
lluczek61
October 2024
N345 Date range not valid with units submitted
336
views
2
comments
0
points
Most recent by
kay.larsen@ah.org
May 2024
Appeal Letter Templates
1K
views
7
comments
0
points
Most recent by
slgincconsulting@aol.com
January 2023
Utilization Mgmt under Revenue Integrity
250
views
1
comment
0
points
Most recent by
mrborden
January 2023
Decision matrix for audit appeals
279
views
1
comment
0
points
Most recent by
laura.tierney@dchstx.org
November 2022
Org chart
138
views
0
comments
0
points
Started by
kshumpert
March 2022
unwarranted denials IP or OP? from Specific payers UHC or Humana
830
views
5
comments
0
points
Most recent by
RHirsch
January 2022
RAC Baseline Additional Documentation Request (ADR) Limits
113
views
0
comments
0
points
Started by
Andrew.Reiten
January 2022
IP LOC and DRG/Coding Clinical Validation on the same encounter
120
views
0
comments
0
points
Started by
christy.basden@iredellhealth.org
January 2022
Humana denials on chemo waste based on vial size
474
views
2
comments
0
points
Most recent by
HeatherDubois
November 2021
OR Base Rate Charge
641
views
5
comments
0
points
Most recent by
catherine-fiala@uiowa.edu
October 2021
Medicare and Medicare MA Inpatient denials - Change the patient status from IP to OP or leave?
254
views
1
comment
0
points
Most recent by
RHirsch
September 2021
Denial prevention committees
616
views
4
comments
0
points
Most recent by
virginialbryan@gmail.com
April 2021
Templates perhaps for appeal rationale for Sepsis (Sepsis-3) and Severe Malnutrition denials.
238
views
1
comment
0
points
Most recent by
virginialbryan@gmail.com
April 2021
Appeal metrics
531
views
3
comments
0
points
Most recent by
ptwiss
December 2020
room and board what's included how to stop denials
763
views
4
comments
0
points
Most recent by
dsoult
September 2020
Cigna Denials per their Reimbursement Policy
1.2K
views
2
comments
0
points
Most recent by
mglynn431
April 2020
UHC denails
170
views
0
comments
0
points
Started by
mglynn431
April 2020
Readmission within 30 days denial
505
views
1
comment
0
points
Most recent by
ronaldhirsch
November 2019
readmisson
213
views
1
comment
0
points
Most recent by
RHirsch
April 2019
Winning DRG appeal but getting denied for Clinical Validation
380
views
1
comment
0
points
Most recent by
RHirsch
June 2018
Physician Advisor Services
180
views
0
comments
0
points
Started by
btadwalt
March 2018