Denials

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

Discussion	Started By	Replies	Views	Most Recent
New vs Acute CHF	Dyan_Post_17992 October 4	1	80	annnd2009@gmail.com October 5
GLIM criteria as basis for UHC denial for SPCM	cynthia.mead@nahealth.com October 2022	1	111	heidi.hillstrom@slhduluth.com August 6
Productivity Standards for Denials	olga.desiatkin@pvhmc.org July 2022	2	120	heidi.hillstrom@slhduluth.com August 6
Cotiviti Denials for VA patients?	robbimorris@sheridanhospital.org May 2	1	69	heidi.hillstrom@slhduluth.com August 6
Sepsis-3 denial letter sample	nzd1980 May 2019	18	1.7K	heidi.hillstrom@slhduluth.com August 6
hospital criteria for acute respiratory failure	myu1@valleyhealth.com April 16	0	115	myu1@valleyhealth.com April 16
Sepsis 2	Smbeckwith February 5	1	138	dbutler@vidanthealth.com April 11
Denial Related to Principle Diagnosis / Federal Registry	christine.butka@hmhn.org January 2022	3	257	cynthia.mead@nahealth.com January 4
Clinical Validation for Sepsis when payer uses Sepsis-3	free2bkari@yahoo.com November 2022	1	108	terrasproles@hotmail.com November 2022
allowable days	Angela.Edwards1@hshs.org May 2022	3	102	olga.desiatkin@pvhmc.org July 2022
Escalation	lmcluckie@wchosp.org July 2022	0	55	lmcluckie@wchosp.org July 2022
Orientation	kshumpert May 2022	0	59	kshumpert May 2022
Patient Status Denials	Angela.Edwards1@hshs.org June 2021	2	167	JMontg01 April 2022
Who uses Epic as a DRG denials platform?	nicole.newman March 2022	0	93	nicole.newman March 2022
Payer reviews	tracey-h February 2022	0	73	tracey-h February 2022
2021 DRG Denials	jaimeiam December 2021	1	307	jcjohnson@premierhealth.com December 2021
After a 3rd level appeal	cdrum July 2019	5	427	hmhmay@ymail.com December 2021
Denial after claim, but before audit!	bbogda55@gmail.com July 2021	2	140	kshumpert November 2021
PSI Events	mcrawfor October 2021	0	224	mcrawfor October 2021
Payers not following coding clinic?	jozog@cayugamed.org September 2021	1	841	kshumpert October 2021
Metabolic Acidosis	alee2020 February 2019	5	1.6K	evanspx@sutterhealth.org June 2021
Short Stay Denials for total knee replacements	lauraehrlich@sunstoneconsulting.com April 2021	1	92	jcjohnson@premierhealth.com May 2021
Denial RN	Kerry.Termaat@phci.org April 2021	2	189	jcjohnson@premierhealth.com April 2021
Malnutrition Denials	melanie.halpern April 2016	17	1.8K	stacy.vincent@enloe.org April 2021
Acute Renal Failure Denial	mbushey@tdstelme.net January 2021	5	423	evanspx@sutterhealth.org April 2021
Queries in Appeal letters	hrboissonneault February 2021	1	189	m1ghtymurs3 February 2021
Escalating to ALJ	mlsswlknsn122@gmail.com February 2021	0	94	mlsswlknsn122@gmail.com February 2021
When did GLIM become accepted criteria to determine Malnutrition	pattyvitasinski@comcast.net November 2020	4	393	pattyvitasinski@comcast.net November 2020
Acute Blood Loss Anemia	cgoewey November 2020	0	320	cgoewey November 2020
Sepsis	hrboissonneault October 2020	3	358	m1ghtymurs3 October 2020

Denials

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