DENIALS & APPEALS

Discussion List

• IP LOC and DRG/Coding Clinical Validation on the same encounter

  3 views 0 comments 0 points Started by christy.basden@iredellhealth.org January 20
• Humana denials on chemo waste based on vial size

  37 views 2 comments 0 points Most recent by HeatherDubois November 2021
• OR Base Rate Charge

  58 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?

  37 views 1 comment 0 points Most recent by RHirsch September 2021
• Denial prevention committees

  144 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.

  43 views 1 comment 0 points Most recent by virginialbryan@gmail.com April 2021
• Appeal metrics

  92 views 3 comments 0 points Most recent by ptwiss December 2020
• room and board what's included how to stop denials

  184 views 4 comments 0 points Most recent by dsoult September 2020
• Cigna Denials per their Reimbursement Policy

  313 views 2 comments 0 points Most recent by mglynn431 April 2020
• UHC denails

  73 views 0 comments 0 points Started by mglynn431 April 2020
• Readmission within 30 days denial

  227 views 1 comment 0 points Most recent by ronaldhirsch November 2019
• readmisson

  75 views 1 comment 0 points Most recent by RHirsch April 2019
• unwarranted denials IP or OP? from Specific payers UHC or Humana

  203 views 2 comments 0 points Most recent by BCSE20 December 2018
• Winning DRG appeal but getting denied for Clinical Validation

  212 views 1 comment 0 points Most recent by RHirsch June 2018
• Physician Advisor Services

  112 views 0 comments 0 points Started by btadwalt March 2018