Appealability: Assessing and Rating a Denial for the Possibility of Overturn
Wednesday, Sept. 11 at 2 p.m. Eastern Time
Join us as we teach you how to develop your own payer-specific scoring system based on the type of denial and how to implement it to ensure your resources are focused on the best chances for recoupment of denied dollars.
Hosted by: Denise Wilson MS,RN,RRT
Vice President, Clinical Appeal Services
In today’s environment of increasing audits and denials many hospitals are finding they don’t have adequate resources to keep up with the demands of appealing denials. It may not make sense to go after all denied claims. The better approach may be to employ your current resources to appealing the denials with the best chance for overturn. Most appeal writers develop pretty quickly a sense of which denied claims have a chance of being overturned and which ones don’t. Have you ever thought of putting your instinctual thinking about the possibility of overturn down on paper? That exercise alone can help make clear what elements are needed in medical record documentation to support the claim as billed. Marry that up to a scoring system, compare that to your successes and you’ll soon have a proven method to identify the denials with the better chances of overturns.
At the end of the webinar the attendee will be able to:
- List the elements required in medical record documentation for a successful appeal
- Select and assign a scoring system that is specific to the denial issue
- Assess the accuracy of the scoring system