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 | Mar 25, 2015 | Appeal Writing, Appeals, Resources, Standards of Care
Limitation on Liability is a very common phrase to appeal writers, specifically when dealing with government denials. It’s a crucial argument that is vital to a winning appeal argument. Have you ever stopped to think about what that phrase means? Have you ever dug...
by | Feb 26, 2015 | Appeal Writing, Appeals, Resources, Standards of Care
There is no reason to ever write an appeal letter from scratch. You will never write just one appeal for chest pain or knee replacement surgery. Denials come in multiples. The only difference from the first chest pain denial and the twentieth is the circumstances of...
by | Feb 10, 2015 | Appeal Writing, Appeals, Resources, Standards of Care
When I teach appeal writing, I like to ask the group this question, “Which knowledge area in appeal writing is the most important? Is it knowledge of the payer, knowledge of the area of medicine concerning the denial, or is it knowledge of the hospital and the...
