Appeal Letter Templates
We are working on a number of items with a consulting firm and one of the discussions that keeps occurring has to do with creating template appeal letters. They are encouraging us to create these based on successful appeals per service. Wondering if others have gone down this road?
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I am also a consultant but I would agree with the consulting firm that directed you to moved towards templates. There are a variety of reasons these assist in overturns. They force your staff to not forget and address key issues, some more common references can be included and or deleted when not applicable. They really help for a more consistent and timely response. That being said, they are only a tool. It still requires qualified staff to write the appeals.
Have you had success in creating these templates? I would love to have a broader discussion on what everyone is seeing in Optum and Equion denials. Our results seem to be very inconsistent.
I would be interested in hearing more information about the success of the templated letters. Our facility doesn't seem very successful in getting an appeal overturned to result in claim payment.
We utilize a template that is partly SmartText in Epic which reduces some of the clerical time for my appeal writers
does anyone have a template they are willing to share? thank you
Were you able to find a template? I would also be interested.
If any of the denials and appeals are related to the Emergency Department, ACEP provides a number of templates for download from its website. Now, keep in mind that these are often geared to the physician perspective, but could be easily be modified for facility use: https://www.acep.org/administration/reimbursement/templated-letters-for-appealing-denied-claims/templated-letters-for-appealing-denied-claims/