DENIALS & APPEALS

Discussion List

• NDC box vs vial

  57 views 0 comments 0 points Started by Llawther January 24
• Appeal Letter Templates

  209 views 7 comments 0 points Most recent by slgincconsulting@aol.com January 12
• Utilization Mgmt under Revenue Integrity

  56 views 1 comment 0 points Most recent by mrborden January 11
• Decision matrix for audit appeals

  66 views 1 comment 0 points Most recent by Lauraltierney November 2022
• Org chart

  61 views 0 comments 0 points Started by kshumpert March 2022
• unwarranted denials IP or OP? from Specific payers UHC or Humana

  336 views 5 comments 0 points Most recent by RHirsch January 2022
• RAC Baseline Additional Documentation Request (ADR) Limits

  45 views 0 comments 0 points Started by Andrew.Reiten January 2022
• IP LOC and DRG/Coding Clinical Validation on the same encounter

  51 views 0 comments 0 points Started by christy.basden@iredellhealth.org January 2022
• Humana denials on chemo waste based on vial size

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

  97 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?

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

  184 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.

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

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

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

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

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

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

  97 views 1 comment 0 points Most recent by RHirsch April 2019
• Winning DRG appeal but getting denied for Clinical Validation

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

  122 views 0 comments 0 points Started by btadwalt March 2018