by Malissa Powers | Apr 22, 2019 | Appeal Writing, Insurance Denials
Earlier this month, Intersect’s article “Coding Denial Trends—How to Create an Effective Appeal Strategy” was published in HFMA’s Revenue Cycle Strategist. As our company’s coding appeals manager, I had an opportunity to share information and insights in response to...
by Denise Wilson | Mar 27, 2019 | Appeal Writing, Appeals, Uncategorized
Facility appeal writers must craft piles of appeals, with virtually no time to investigate the accuracy of payer denials. However, understanding the appeal process is crucial. Engaging a physician advisor can bring the knowledge and experience of a physician to the...
by Intersect Healthcare | Oct 22, 2018 | Appeal Writing, Medicare, Revenue Cycle
By R. Kendall Smith, Jr., MD, SFHM A report released by the HHS Office of Inspector General (OIG) in September 2018 found that Medicare Advantage Organizations (MAOs) overturned a jaw-dropping 75 percent of their own denials from 2014 to 2016. Even more startling was...
by Intersect Healthcare | Apr 5, 2017 | Appeal Writing, Appeals, Medical Records, Medicare, Resources
Reprinted with permission by the Report on Medicare Compliance Fed up with claim denials for inpatient admissions by Medicare Advantage (MA) plans months after they were approved, Self Regional Healthcare in Greenwood, S.C., complained to the CMS regional office in...
by | Jul 3, 2015 | Appeal Writing, Appeals, Evidence Based Guidelines, Medical Records, Resources, Standards of Care
Including payer payment guidelines in your appeal letter templates can increase the efficiency and effectiveness of your appeal writing. Most payers develop and publish very specific payment guidelines for medical and surgical procedures. This ensures payment is made...
by | Jun 4, 2015 | Appeal Writing, Appeals, Evidence Based Guidelines, Medical Records, Resources, Standards of Care
Insurance company denials of payment are rarely issued in a random and infrequent manner. Most denials for services rendered are grouped around specific issues on payment policies, as defined by the insurance carrier. As an appeal writer, it only makes sense to...
