4 tips to win on telephone appeals

Why This Topic Matters

Telephone appeal handling can save time, but only if the practice is prepared and understands the limits of what contractors may address by phone. Knowing the broad guidance and operational cautions can help reduce delays and avoid missteps in the appeals process.

Article Sections

1. Telephone appeals overview and Medicare guidance

   Introduces telephone appeals for Medicare denials and notes that contractor handling may vary. References CMS and Medicare manual guidance on when an appeal may be resolved by phone or routed to written review.

2. Preparation before placing the call

   Discusses the importance of gathering supporting documentation and acting promptly after a denial. Describes assigning responsibility for managing the appeal process within the practice.

3. Cautions during recorded calls

   Explains that telephone appeals may be recorded and highlights the need to be careful with conversational language. Notes the potential advantages and limitations of using the phone instead of writing.

4. Limits on issues handled by phone

   Describes the kinds of matters that may be suitable for telephone appeal and indicates that more complex issues may not be handled this way. Includes an example of contractor-specific limits discussed in the article.