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How well are Statutory Documentation Requirements Decreasing CMS Program Risks?

by Denise Wilson | Apr 5, 2019 | Appeals, Insurance Denials, Revenue Cycle

The Government Accountability Office (GAO) issued a report on March 27, 2019, stating CMS should assess documentation necessary to identify improper payments. The study was performed on Medicare FFS and Medicaid FFS improper payment data for four selected services...

How Less Than a Half of an Inch Cost a Hospital > $1,700 in Denied Payment

by Denise Wilson | Nov 14, 2018 | Appeals, Insurance Denials, Uncategorized

by Denise Wilson, RN, MS, RRT, Vice President, Clinical Appeal Services, Intersect Healthcare Reproduced with permission of ACPA A large national insurance carrier, offering managed Medicaid plans, recently denied the inclusion of ICD-10-CM codes Z68.41, body mass...

Regulatory Waivers, EMTALA Exemptions Effective During Hurricane Harvey

by Intersect Healthcare | Sep 8, 2017 | Appeals, Insurance Denials, Resources, Standards of Care, Veracity Software

Permission to reproduce granted by RACmonitor By Denise Wilson, RN, MS, RRT EDITOR’S NOTE: With Hurricane Irma expected to impact Miami-County today, this story, updated from a news alert posted last week on the ICD10monitor website, offers lessons learned for...

The Missing Wheel on the Revenue Cycle

by Intersect Healthcare | Jun 14, 2017 | Appeals, Insurance Denials, Resources, Revenue Cycle, Veracity Software

Practical steps to reduce insurance denials and steadily improve the bottom line By Kendall Smith, MD | Chief Physician Advisor to the Intersect Healthcare Leadership Team I was writing an appeal for a hospital system the other day to a large insurer. It was one of...

Appealing Medicare Advantage Denials For Patients Gives Hospitals More Leverage

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...

Why You Should Include Payer Payment Guidelines in Appeal Templates

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...
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PayerWatch is your ally in preventing denials and winning appeals. 

To better reflect our laser focus on serving healthcare providers, we are excited to announce that we are renaming Intersect Healthcare to PayerWatch.

For more information, please email info@payerwatch.com.

 

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