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DENIALS & APPEALS
Discuss topics such as denials management, appeals strategies, external auditors, and more.
Discussion List
N345 Date range not valid with units submitted
31
views
2
comments
0
points
Most recent by
kay.larsen@ah.org
May 30
NDC box vs vial
110
views
0
comments
0
points
Started by
Llawther
January 2023
Appeal Letter Templates
300
views
7
comments
0
points
Most recent by
slgincconsulting@aol.com
January 2023
Utilization Mgmt under Revenue Integrity
93
views
1
comment
0
points
Most recent by
mrborden
January 2023
Decision matrix for audit appeals
124
views
1
comment
0
points
Most recent by
Lauraltierney
November 2022
Org chart
86
views
0
comments
0
points
Started by
kshumpert
March 2022
unwarranted denials IP or OP? from Specific payers UHC or Humana
384
views
5
comments
0
points
Most recent by
RHirsch
January 2022
RAC Baseline Additional Documentation Request (ADR) Limits
56
views
0
comments
0
points
Started by
Andrew.Reiten
January 2022
IP LOC and DRG/Coding Clinical Validation on the same encounter
66
views
0
comments
0
points
Started by
christy.basden@iredellhealth.org
January 2022
Humana denials on chemo waste based on vial size
203
views
2
comments
0
points
Most recent by
HeatherDubois
November 2021
OR Base Rate Charge
125
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?
130
views
1
comment
0
points
Most recent by
RHirsch
September 2021
Denial prevention committees
201
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.
93
views
1
comment
0
points
Most recent by
virginialbryan@gmail.com
April 2021
Appeal metrics
199
views
3
comments
0
points
Most recent by
ptwiss
December 2020
room and board what's included how to stop denials
372
views
4
comments
0
points
Most recent by
dsoult
September 2020
Cigna Denials per their Reimbursement Policy
858
views
2
comments
0
points
Most recent by
mglynn431
April 2020
UHC denails
112
views
0
comments
0
points
Started by
mglynn431
April 2020
Readmission within 30 days denial
332
views
1
comment
0
points
Most recent by
ronaldhirsch
November 2019
readmisson
110
views
1
comment
0
points
Most recent by
RHirsch
April 2019
Winning DRG appeal but getting denied for Clinical Validation
270
views
1
comment
0
points
Most recent by
RHirsch
June 2018
Physician Advisor Services
128
views
0
comments
0
points
Started by
btadwalt
March 2018