Denials

Discuss topics related to denials management, prevention, and appeals.

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Denial for AKI "after optimal hydration"
rmalcolm@cvph.orgrmalcolm@cvph.org
0
110
rmalcolm@cvph.orgrmalcolm@cvph.org
Sepsis and Acute respiratory failure - calculated versus ABG P/F ratios
JlwardJlward
0
171
JlwardJlward
Acute Blood Loss Anemia
cgoeweycgoewey
3
663
Sarah.priceSarah.price
Malnutrition Denials
melanie.halpernmelanie.halpern
18
1.9K
JlwardJlward
hospital criteria for acute respiratory failure
myu1@valleyhealth.commyu1@valleyhealth.com
1
196
JlwardJlward
Sepsis-3 denial letter sample
nzd1980nzd1980
20
1.8K
seaboldsseabolds
New vs Acute CHF
Dyan_Post_17992Dyan_Post_17992
1
118
annnd2009@gmail.comannnd2009@gmail.com
GLIM criteria as basis for UHC denial for SPCM
cynthia.mead@nahealth.comcynthia.mead@nahealth.com
1
133
heidi.hillstrom@slhduluth.comheidi.hillstrom@slhduluth.com
Productivity Standards for Denials
olga.desiatkin@pvhmc.orgolga.desiatkin@pvhmc.org
2
144
heidi.hillstrom@slhduluth.comheidi.hillstrom@slhduluth.com
Cotiviti Denials for VA patients?
robbimorris@sheridanhospital.orgrobbimorris@sheridanhospital.org
1
91
heidi.hillstrom@slhduluth.comheidi.hillstrom@slhduluth.com
Sepsis 2
SmbeckwithSmbeckwith
1
161
dbutler@vidanthealth.comdbutler@vidanthealth.com
Denial Related to Principle Diagnosis / Federal Registry
christine.butka@hmhn.orgchristine.butka@hmhn.org
3
282
cynthia.mead@nahealth.comcynthia.mead@nahealth.com
Clinical Validation for Sepsis when payer uses Sepsis-3
free2bkari@yahoo.comfree2bkari@yahoo.com
1
127
terrasproles@hotmail.comterrasproles@hotmail.com
allowable days
aedwards@iodinesoftware.comaedwards@iodinesoftware.com
3
117
olga.desiatkin@pvhmc.orgolga.desiatkin@pvhmc.org
Escalation
lmcluckie@wchosp.orglmcluckie@wchosp.org
0
58
lmcluckie@wchosp.orglmcluckie@wchosp.org
Orientation
kshumpertkshumpert
0
63
kshumpertkshumpert
Patient Status Denials
aedwards@iodinesoftware.comaedwards@iodinesoftware.com
2
180
JMontg01JMontg01
Who uses Epic as a DRG denials platform?
nicole.newmannicole.newman
0
105
nicole.newmannicole.newman
Payer reviews
tracey-htracey-h
0
90
tracey-htracey-h
2021 DRG Denials
jaimeiamjaimeiam
1
326
jcjohnson@premierhealth.comjcjohnson@premierhealth.com
After a 3rd level appeal
cdrumcdrum
5
465
hmhmay@ymail.comhmhmay@ymail.com
Denial after claim, but before audit!
bbogda55@gmail.combbogda55@gmail.com
2
154
kshumpertkshumpert
PSI Events
mcrawformcrawfor
0
261
mcrawformcrawfor
Payers not following coding clinic?
jozog@cayugamed.orgjozog@cayugamed.org
1
974
kshumpertkshumpert
Metabolic Acidosis
alee2020alee2020
5
1.8K
evanspx@sutterhealth.orgevanspx@sutterhealth.org
Short Stay Denials for total knee replacements
lauraehrlich@sunstoneconsulting.comlauraehrlich@sunstoneconsulting.com
1
98
jcjohnson@premierhealth.comjcjohnson@premierhealth.com
Denial RN
Kerry.Termaat@phci.orgKerry.Termaat@phci.org
2
199
jcjohnson@premierhealth.comjcjohnson@premierhealth.com
Acute Renal Failure Denial
mbushey@tdstelme.netmbushey@tdstelme.net
5
455
evanspx@sutterhealth.orgevanspx@sutterhealth.org
Queries in Appeal letters
hrboissonneaulthrboissonneault
1
213
m1ghtymurs3m1ghtymurs3
Escalating to ALJ
mlsswlknsn122@gmail.commlsswlknsn122@gmail.com
0
104
mlsswlknsn122@gmail.commlsswlknsn122@gmail.com