DENIALS & APPEALS

Discussion List

• N345 Date range not valid with units submitted

  4 views 0 comments 0 points Started by kay.larsen@ah.org April 16
• NDC box vs vial

  105 views 0 comments 0 points Started by Llawther January 2023
• Appeal Letter Templates

  286 views 7 comments 0 points Most recent by slgincconsulting@aol.com January 2023
• Utilization Mgmt under Revenue Integrity

  85 views 1 comment 0 points Most recent by mrborden January 2023
• Decision matrix for audit appeals

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

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

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

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

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

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

  116 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?

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

  195 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.

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

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

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

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

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

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

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

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

  126 views 0 comments 0 points Started by btadwalt March 2018