Denial Appeals
Does anyone include physicians in the review of diagnosis denials or seek their input on the appeal letter writing?
Thank you for any input.
Lisa
Tagged:
Does anyone include physicians in the review of diagnosis denials or seek their input on the appeal letter writing?
Thank you for any input.
Lisa
Comments
Yes, You can, and why not? Let them also know, what CDI, reviewers, and coders are being challenged by external payers, it affects reimbursement and unnecessary delay and correspondence front and back. Furthermore, Physicians are also made aware of when documenting and diagnosing in the future with clinical treatment and resources. Finally, keep in mind it is not about reimbursement alone, more departments review and correct assignments of diagnoses of patients' profiles/bills. its team work.
Edward
I am the physician advisor for my hospital. We spilt the denial letters into a coding issue and more documentation/clinical issue. I write all the latter appeals myself. I also request reviews from fellow physicians with diagnoses I have less or no experience with such as those involving neonates.