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...
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...
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...
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...
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...
