Denial Resources

nrshuffy@gmail.comnrshuffy@gmail.com
edited August 5 in Denials

I recently inherited managing denials for one of our facilities, but I am having trouble finding resources to use when writing the appeals. The majority of denials utilize UpToDate as a reference which I do not have access. I find it very difficult to search through pub med for articles as well. What are some of the resources used when trying to write appeal letters? I have used Pinson and Tang, ACDIS, articles from JAMA but have not been very successful. I am also finding that it has been the process for the appeal letters being sent back have been including highlighted segments, bolding words, different color font to emphasize certain items. I have been under the impression that this is not the best way to compose appeal letters. If anyone has examples of appeal letters without patient identifiers that they could share, I would appreciate it.


Thanks

Kelley Huff, RN

Comments

  • Rutland2023Rutland2023

    Hi Kelly,

    I have the book CDI Field Guide to Denial Prevention and Audit Defenseby Trey La Charite published by ACDIS and available in the HCPRO store. There are sample appeal letters at the end and also good examples within it as well. You should also propose getting UpToDate at your facility as it is widely used both by providers and clinicians and can provide CE's to providers.

    Tracie

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