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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...

The Use of Evidence Based Medicine in Appeal Letter Templates

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...

Are CMS’ Local Coverage and National Coverage Determinations the Final Word?

by | Mar 18, 2015 | Appeals, Medical Records, Resources, Standards of Care

RAC, CERT, ZPIC, MAC. These are acronyms that send shudders through most hospital’s C-Suites, given their perpetually increasing aggressiveness of “un-paying” hospitals, and now physicians1. Understanding LCD’s and NCD’s A majority of these “un-payments”...

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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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