DENIALS & APPEALS

Discussion List

• Utilization Mgmt under Revenue Integrity

  3 views 0 comments 0 points Started by eileen.sullivan@atlantichealth.org September 26
• Appeal Letter Templates

  83 views 5 comments 0 points Most recent by tina.bui@childrenscolorado.org June 22
• Org chart

  30 views 0 comments 0 points Started by kshumpert March 2
• unwarranted denials IP or OP? from Specific payers UHC or Humana

  285 views 5 comments 0 points Most recent by RHirsch January 26
• RAC Baseline Additional Documentation Request (ADR) Limits

  18 views 0 comments 0 points Started by Andrew.Reiten January 26
• IP LOC and DRG/Coding Clinical Validation on the same encounter

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

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

  76 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?

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

  162 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.

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

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

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

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

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

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

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

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

  116 views 0 comments 0 points Started by btadwalt March 2018