Appeal Tip Of The Week

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127
Location
Bradenton, Florida
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I would like to offer my colleagues a tip of the week from the health plan side of the industry. Hopefully these tips will assist you in faster appeal decisions & resolution to outstanding A/R. I can't promise resolution will come in the form of payment but the faster the resolution the faster you can get it off the A/R.

Tip of the week 05/06/12 - 05/13/12

When submitting an appeal to the payer make sure to include the intent of the appeal and for what services you are appealing. When we receive an appeal even though we can see what was denied, if your letter doesn't specificaly state what your appealing, the appeal will be closed with no action. This could prolong the outstanding balance on your A/R for several more weeks and make the difference of what your A/R receivables look like at the end of the month.

Believe it or not we receive appeals with little to no information frequently.

Not all payers follow the same guidelines. This tip however, will only help you no matter which payer you're dealing with.
 

ollielooya

True Blue
Messages
900
Location
Everett, WA
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Nicole, your TIP of the Week is a wonderful idea and greatly appreciated! I would love for our local chapter to have a rep from one of the local/major carriers come in and address these issues. I'm looking forward to your next one already!!! Great advice and thank you.
 
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