New to Denials

Hi all!

I am new to working on denials at my facility and am looking for some good resources to help me expand my knowledge in working on the appeals process - what works, what doesn't work, best practices, etc. Are there any good articles or webinars to explore? Any direction would be helpful. Thanks!

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Comments

  • Hi Becky!

    Intersect Healthcare (Appeal Masters) has great webinars on "Successfully Appealing..." various topics.  You can sign up for them for free, as long as you have an organizational email address (no yahoo, gmail, or Hotmail allowed).  I have successfully appealed several denials regarding noncompliance or adherence to the AHIMA Practice Brief: Guidelines for Achieving a Compliant Query Practice. I recommend using a bullet point format or break down by "elements" with the elements being each point the payer denied (restating their exact language).  Refute each element with supporting clinical information and cite sources for that particular element. 

    Some providers use "narrative" format; I don't recommend that format, neither does Appeal Masters. Narrative format can easily distract or lose the reader/audience. 

    I hope this helps!

    Sincerely,

    Angelica N.

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