Denials

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

Discussion List

Discussion
Started By
Replies
Views
Most Recent
How many bites at the apple are audit companies allowed?
Announcement
Shannon.DiSilvestroShannon.DiSilvestro
2
102
Shannon.DiSilvestroShannon.DiSilvestro
Different Sepsis criteria used by different payers
DeannaLaDueDeannaLaDue
1
47
cgoeweycgoewey
Reporting and EPIC
cgoeweycgoewey
0
26
cgoeweycgoewey
Who uses Epic as a DRG denials platform?
nicole.newmannicole.newman
2
230
ellen.ellis@mymlc.comellen.ellis@mymlc.com
Escalation
lmcluckie@wchosp.orglmcluckie@wchosp.org
2
177
cgoeweycgoewey
Denial Related to Principle Diagnosis / Federal Registry
christine.butka@hmhn.orgchristine.butka@hmhn.org
4
559
Shannon.DiSilvestroShannon.DiSilvestro
Managing DRG Denials
elaine.koetje@spectrumhealth.orgelaine.koetje@spectrumhealth.org
3
415
Shannon.DiSilvestroShannon.DiSilvestro
Queries in Appeal letters
hrboissonneaulthrboissonneault
7
537
Shannon.DiSilvestroShannon.DiSilvestro
Cotiviti and Cross Claim Review Denials
Shannon.DiSilvestroShannon.DiSilvestro
1
499
Shannon.DiSilvestroShannon.DiSilvestro
Sepsis and Acute respiratory failure - calculated versus ABG P/F ratios
JlwardJlward
2
552
amarin.alexander@fideliscare.orgamarin.alexander@fideliscare.org
Denial for AKI "after optimal hydration"
rmalcolm@cvph.orgrmalcolm@cvph.org
4
1.1K
cgoeweycgoewey
Acute Blood Loss Anemia
cgoeweycgoewey
3
2.2K
Sarah.priceSarah.price
Malnutrition Denials
melanie.halpernmelanie.halpern
18
2.2K
JlwardJlward
hospital criteria for acute respiratory failure
myu1@valleyhealth.commyu1@valleyhealth.com
1
507
JlwardJlward
Sepsis-3 denial letter sample
nzd1980nzd1980
20
2.3K
seaboldsseabolds
New vs Acute CHF
Dyan_Post_17992Dyan_Post_17992
1
515
annnd2009@gmail.comannnd2009@gmail.com
GLIM criteria as basis for UHC denial for SPCM
cynthia.mead@nahealth.comcynthia.mead@nahealth.com
1
325
heidi.hillstrom@slhduluth.comheidi.hillstrom@slhduluth.com
Productivity Standards for Denials
olga.desiatkin@pvhmc.orgolga.desiatkin@pvhmc.org
2
348
heidi.hillstrom@slhduluth.comheidi.hillstrom@slhduluth.com
Cotiviti Denials for VA patients?
robbimorris@sheridanhospital.orgrobbimorris@sheridanhospital.org
1
234
heidi.hillstrom@slhduluth.comheidi.hillstrom@slhduluth.com
Sepsis 2
SmbeckwithSmbeckwith
1
313
dbutler@vidanthealth.comdbutler@vidanthealth.com
Clinical Validation for Sepsis when payer uses Sepsis-3
free2bkari@yahoo.comfree2bkari@yahoo.com
1
288
terrasproles@hotmail.comterrasproles@hotmail.com
allowable days
aedwards@iodinesoftware.comaedwards@iodinesoftware.com
3
294
olga.desiatkin@pvhmc.orgolga.desiatkin@pvhmc.org
Orientation
kshumpertkshumpert
0
125
kshumpertkshumpert
Patient Status Denials
aedwards@iodinesoftware.comaedwards@iodinesoftware.com
2
346
JMontg01JMontg01
Payer reviews
tracey-htracey-h
0
147
tracey-htracey-h
2021 DRG Denials
jaimeiamjaimeiam
1
466
jcjohnson@premierhealth.comjcjohnson@premierhealth.com
After a 3rd level appeal
cdrumcdrum
5
713
hmhmay@ymail.comhmhmay@ymail.com
Denial after claim, but before audit!
bbogda55@gmail.combbogda55@gmail.com
2
313
kshumpertkshumpert
PSI Events
mcrawformcrawfor
0
480
mcrawformcrawfor
Payers not following coding clinic?
joanozog1@gmail.comjoanozog1@gmail.com
1
1.7K
kshumpertkshumpert