Denials

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

Discussion	Started By	Replies	Views	Most Recent
Sepsis and Acute respiratory failure - calculated versus ABG P/F ratios	Jlward February 11	1	251	cgoewey October 10
Denial for AKI "after optimal hydration"	rmalcolm@cvph.org March 21	4	529	cgoewey October 10
Managing DRG Denials	elaine.koetje@spectrumhealth.org September 23	0	22	elaine.koetje@spectrumhealth.org September 23
Acute Blood Loss Anemia	cgoewey November 2020	3	1.3K	Sarah.price January 23
Malnutrition Denials	melanie.halpern April 2016	18	2K	Jlward December 2023
hospital criteria for acute respiratory failure	myu1@valleyhealth.com April 2023	1	278	Jlward December 2023
Sepsis-3 denial letter sample	nzd1980 May 2019	20	1.9K	seabolds December 2023
New vs Acute CHF	Dyan_Post_17992 October 2023	1	211	annnd2009@gmail.com October 2023
GLIM criteria as basis for UHC denial for SPCM	cynthia.mead@nahealth.com October 2022	1	180	heidi.hillstrom@slhduluth.com August 2023
Productivity Standards for Denials	olga.desiatkin@pvhmc.org July 2022	2	188	heidi.hillstrom@slhduluth.com August 2023
Cotiviti Denials for VA patients?	robbimorris@sheridanhospital.org May 2023	1	134	heidi.hillstrom@slhduluth.com August 2023
Sepsis 2	Smbeckwith February 2023	1	206	dbutler@vidanthealth.com April 2023
Denial Related to Principle Diagnosis / Federal Registry	christine.butka@hmhn.org January 2022	3	335	cynthia.mead@nahealth.com January 2023
Clinical Validation for Sepsis when payer uses Sepsis-3	free2bkari@yahoo.com November 2022	1	176	terrasproles@hotmail.com November 2022
allowable days	aedwards@iodinesoftware.com May 2022	3	163	olga.desiatkin@pvhmc.org July 2022
Escalation	lmcluckie@wchosp.org July 2022	0	73	lmcluckie@wchosp.org July 2022
Orientation	kshumpert May 2022	0	76	kshumpert May 2022
Patient Status Denials	aedwards@iodinesoftware.com June 2021	2	217	JMontg01 April 2022
Who uses Epic as a DRG denials platform?	nicole.newman March 2022	0	118	nicole.newman March 2022
Payer reviews	tracey-h February 2022	0	100	tracey-h February 2022
2021 DRG Denials	jaimeiam December 2021	1	365	jcjohnson@premierhealth.com December 2021
After a 3rd level appeal	cdrum July 2019	5	545	hmhmay@ymail.com December 2021
Denial after claim, but before audit!	bbogda55@gmail.com July 2021	2	193	kshumpert November 2021
PSI Events	mcrawfor October 2021	0	321	mcrawfor October 2021
Payers not following coding clinic?	jozog@cayugamed.org September 2021	1	1.1K	kshumpert October 2021
Metabolic Acidosis	alee2020 February 2019	5	2K	evanspx@sutterhealth.org June 2021
Short Stay Denials for total knee replacements	lauraehrlich@sunstoneconsulting.com April 2021	1	110	jcjohnson@premierhealth.com May 2021
Denial RN	Kerry.Termaat@phci.org April 2021	2	213	jcjohnson@premierhealth.com April 2021
Acute Renal Failure Denial	mbushey@tdstelme.net January 2021	5	493	evanspx@sutterhealth.org April 2021
Queries in Appeal letters	hrboissonneault February 2021	1	255	m1ghtymurs3 February 2021

Denials

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