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...
by | Jan 27, 2015 | Appeals, Evidence Based Guidelines, Resources, Standards of Care
For a new appeal writer, learning the language of health insurance can be daunting, especially if one’s background is clinical and not business oriented. I remember as a newbie reading the CMS regulations on payment policies over and over again. I’d tease out every...
by | Jan 8, 2015 | Appeals, Evidence Based Guidelines, Standards of Care
The inclusion of evidence based guidelines (EBGs) is imperative in appeal writing involving medical necessity denials, including level of care or medical necessity of a procedure. It’s one of the fundamentals but probably the most important aspect of appeal writing....
