LEAGUE CITY, Texas, April 7, 2011 /PRNewswire/ -- Many healthcare organizations do not appeal low balance denials. Instead, minimum dollar amount thresholds dictate which denials are addressed.
Unfortunately, setting an appeal threshold leaves money on the table as insurers focus on high volume, lower balance claim reviews. Automated claims processing makes it easy for carriers to deploy frequent coverage and coding changes which can have a dramatic effect on your organization's financial viability. It is important to appeal non-standard coding denials and require carriers to explain such coding edits, downcodes and denials in a claim-specific manner.
Power of Appeals Denial Management (www.powerofappeals.com) software allows you to efficiently and effectively appeal all unsubstantiated denials, including low balance coding denials. Power of Appeals has been completely redesigned for more efficient electronic import of denials and ongoing management of the appeal process.
Appeal generation has historically been a time-intensive, low return business office activity. However, appeals are increasingly important. Through the appeal process, healthcare organizations can demand disclosure of payer-specific guidance, demand peer review of clinical information and secure the right to pursue external review of denials.
Power of Appeals is the only denial management system with more that 1600 appeal letter templates, including state-specific, specialty-specific and payer-specific appeal letters. Most of the appeal letter templates cite legal information to demand the most comprehensive review from the carrier.
"You have got to cite compliance information in appeals. When the law is in your favor, let carriers know. When the law demands disclosure of the denial information, peer review and external review, you shouldn't have to ask twice," said Tammy Tipton, president of Appeal Solutions Inc.
To assist healthcare organizations manage the denial volume, Power of Appeals can import the 835 file and automatically assign a claim-specific denial type. The Power of Appeals Denials Dashboard allows users to quickly assess Denials By Payer Group/Denial Type/Carrier.
New Power of Appeals reports allow you to generate Day-to-Day Management Reviews, End-of-Month Performance Reports, User Performance Reviews, Payer Performance Reviews and Problem-Focuses Analysis.
Finally Power of Appeals is now directly integrated with AppealLettersOnline.com to allow for constant updates to letter content. A Power of Appeals software demo is available at www.powerofappeals.com. Call Appeal Solutions at 888-399-4925 for more information.
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Tammy Tipton
https://profnet.prnewswire.com/Subscriber/ExpertProfile.aspx?ei=101873
Contact: Tammy Tipton, President Appeal Solutions
888-399-4925 ext 703
[email protected]
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SOURCE Appeal Solutions