AppealMasters

Intersect Healthcare accelerates the appeal process, reduces cost to appeal and protects your margin.

Claim denials from Medicare, Medicaid, and commercial payers are on the rise. And according to industry experts, up to two-thirds of these are recoverable, and almost all (90%) of them are preventable¹. Yet approximately one-third of healthcare providers still use a manual process to manage payer claim denials, according to a recent HIMSS Analytics survey.

Three Payer Denial Appeal Trends to Know

1. Claims appeal process is costly, time-consuming and becoming more complex

2. Median for successful appeals fell to 45% for commercial payers, 41% for Medicaid

3. More denials based on medical necessity rather than technical or demographic error.

A proactive approach is required to boost appeal success rates while reducing overall operational costs. Rely on Intersect Healthcare’s proven expertise to win back the revenue your organization rightfully earned.

CODING DENIAL APPEALS

MEDICAL NECESSITY
DENIAL APPEALS

CLINICAL VALIDATION
DENIAL APPEALS

AppealMasters Revenue Recovery Services

AppealMasters is Intersect Healthcare’s team of specialized revenue recovery experts who assist in responding to all government and commercial payer appeals. Our professionals offer verified services and technology to streamline claim appeals, from initial denial or bench support to any point in the process.

With AppealMasters, your organization benefits from winning appeal letters that include Evidence-based Medicine and NCD guidelines to support the appeal and reference specific findings in the medical record. Over 300 hospitals trust our expertise to appeal payer denials through a comprehensive set of tools and services:

• Guidance in each level of the appeal process
• Advocacy and appeal support until completion of the case
• Ongoing feedback and indicators of potential risk
• Tracking, trending and statistical data analysis
• Process remediation and expertise in preparing a medical case before the ALJ
• Real-time access to appeal activity reports
• Support to correct potential flaws in coding or clinical documentation processes
• Educational opportunities

Intersect Healthcare simplifies your appeal process—resulting in improved cash flow, increased net revenues and fewer compliance concerns. But don’t take our word for it.

Check out the list of hospitals and health systems using our services here.

Take the Next Step: Appeal Education Reduces Costs

AppealMasters is also widely recognized as a leading resource for appeal education and time-saving appeal letter templates designed by industry experts. From educational client webinars to downloadable payer denial and appeal resources, clients discover a plethora of healthcare revenue cycle know-how to boost success rates and cut cost to appeal.

Client hospitals and health systems rely on our clinical experts to:

Provide suggestions for
appeal performance
enhancement

Identify targeted
educational opportunities

Prevent future takebacks
and payer denials

Learn more about how your organization can save time and resources amidst increasing volumes of Medicare, Medicaid and commercial payer denials. With Intersect Healthcare’s AppealMasters team by your side, you’ll write off fewer denials and win more appeals!

¹https://www.advisory.com/research/financial-leadership-council/at-the-margins/2014/12/denials-management

Discover how our technology and appeal services work together to win back your revenue from payer claim denials. Request more information below.