Administration & Management, General Reference, Insurance, Marketing & Sales

Appealing and Preventing Denied Claims [With CDROM]

Name: Appealing and Preventing Denied Claims [With CDROM]
Author: Rosenstein , Rosenstein, Simon D.
ISBN: 9781578393305

by Rosenstein, Simon D.

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Synopsis

Hospitals lose an average of $1,000 a day because of denied claims. Outpatient sites lose an average of $1,200 per day from the same problem. Health plans have very strict approval guidelines. They give providers a large number of forms and letters to wade through and make the claims appeals process generally confusing and time-consuming. Providers need a time-saving resource to help them appeal and reverse unfavorable medical necessity-related health plan claims decisions. Appealing and Preventing Denied Claims, which is applicable to hospital and physician practice settings, uses case studies and scenarios to show: