tci General Surgery Coding Alert - 2011 Issue 8

Reader Question: Skip 'Form Letters' if You're Hoping for Appeals Success

Question: After checking to be sure we haven't made a coding or billing entry error, our practice automatically appeals payer denials using a standard letter. We don't seem to be very successful in ultimately getting payment. How can we improve our appeals process?Texas SubscriberAnswer: Successful appeals depend on knowing coverage rules and providing specific information to make your case. Form letters don't address either of those advantages, so follow these tips to get better appeals results.Check policies: Before you begin the appeal process, first check the payer's policies. If you discover that your surgeon performed a procedure...

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