Denials

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

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Denial Resources
Announcement
nrshuffy@gmail.comnrshuffy@gmail.com
1
75
Rutland2023Rutland2023
CDI question
Announcement
nusrat00@hotmail.comnusrat00@hotmail.com
1
85
kelly.rice@hcpro.comkelly.rice@hcpro.com
Job description
Announcement
dunkelrndunkelrn
0
36
dunkelrndunkelrn
How many bites at the apple are audit companies allowed?
Announcement
Shannon.DiSilvestroShannon.DiSilvestro
2
161
Shannon.DiSilvestroShannon.DiSilvestro
Medicare PROBE for DRG 291
annwitt2annwitt2
0
18
annwitt2annwitt2
Acute Kidney Injury (AKI) with all creatinines WNL
KGoodberryKGoodberry
0
42
KGoodberryKGoodberry
Different Sepsis criteria used by different payers
DeannaLaDueDeannaLaDue
1
103
cgoeweycgoewey
Reporting and EPIC
cgoeweycgoewey
0
60
cgoeweycgoewey
Who uses Epic as a DRG denials platform?
nicole.newmannicole.newman
2
275
ellen.ellis@mymlc.comellen.ellis@mymlc.com
Escalation
lmcluckie@wchosp.orglmcluckie@wchosp.org
2
202
cgoeweycgoewey
Denial Related to Principle Diagnosis / Federal Registry
christine.butka@hmhn.orgchristine.butka@hmhn.org
4
598
Shannon.DiSilvestroShannon.DiSilvestro
Managing DRG Denials
elaine.koetje@spectrumhealth.orgelaine.koetje@spectrumhealth.org
3
539
Shannon.DiSilvestroShannon.DiSilvestro
Queries in Appeal letters
hrboissonneaulthrboissonneault
7
608
Shannon.DiSilvestroShannon.DiSilvestro
Cotiviti and Cross Claim Review Denials
Shannon.DiSilvestroShannon.DiSilvestro
1
668
Shannon.DiSilvestroShannon.DiSilvestro
Sepsis and Acute respiratory failure - calculated versus ABG P/F ratios
JlwardJlward
2
581
amarin.alexander@fideliscare.orgamarin.alexander@fideliscare.org
Denial for AKI "after optimal hydration"
rmalcolm@cvph.orgrmalcolm@cvph.org
4
1.2K
cgoeweycgoewey
Acute Blood Loss Anemia
cgoeweycgoewey
3
2.5K
Sarah.priceSarah.price
Malnutrition Denials
melanie.halpernmelanie.halpern
18
2.3K
JlwardJlward
hospital criteria for acute respiratory failure
myu1@valleyhealth.commyu1@valleyhealth.com
1
553
JlwardJlward
Sepsis-3 denial letter sample
nzd1980nzd1980
20
2.3K
seaboldsseabolds
New vs Acute CHF
Dyan_Post_17992Dyan_Post_17992
1
601
annnd2009@gmail.comannnd2009@gmail.com
GLIM criteria as basis for UHC denial for SPCM
cynthia.mead@nahealth.comcynthia.mead@nahealth.com
1
348
heidi.hillstrom@slhduluth.comheidi.hillstrom@slhduluth.com
Productivity Standards for Denials
olga.desiatkin@pvhmc.orgolga.desiatkin@pvhmc.org
2
377
heidi.hillstrom@slhduluth.comheidi.hillstrom@slhduluth.com
Cotiviti Denials for VA patients?
robbimorris@sheridanhospital.orgrobbimorris@sheridanhospital.org
1
245
heidi.hillstrom@slhduluth.comheidi.hillstrom@slhduluth.com
Sepsis 2
SmbeckwithSmbeckwith
1
350
dbutler@vidanthealth.comdbutler@vidanthealth.com
Clinical Validation for Sepsis when payer uses Sepsis-3
free2bkari@yahoo.comfree2bkari@yahoo.com
1
312
terrasproles@hotmail.comterrasproles@hotmail.com
allowable days
aedwards@iodinesoftware.comaedwards@iodinesoftware.com
3
320
olga.desiatkin@pvhmc.orgolga.desiatkin@pvhmc.org
Orientation
kshumpertkshumpert
0
143
kshumpertkshumpert
Patient Status Denials
aedwards@iodinesoftware.comaedwards@iodinesoftware.com
2
380
JMontg01JMontg01
Payer reviews
tracey-htracey-h
0
158
tracey-htracey-h