LEAGUE CITY, Texas, Sept. 8 /PRNewswire/ -- Does your lengthy appeal letter attached to an even lengthier medical record result in two words from the carrier?
"Denial upheld" is a favorite health insurer appeal response. However, form letter denials lacking a detailed explanation are just one of the medical claim problems the Patient Protection and Affordable Care Act aims to stop.
Appeal Solutions has updated their most popular appeals audio conference with new PPACA protections. "25 Proven Appeal Letters and Using PPACA in Provider Appeals" will focus on the most valuable legal protections related to medical claim processing and how to demand high quality appeal review of denials.
"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 Tipton, president of Appeal Solutions Inc. and author of several denial management products and publications.
PPACA, ERISA regulations and state laws contain a number of protections related to inappropriate delays and denials. Many medical providers do not understand how these regulations work in conjunction to the benefit of both provider and patient. The upcoming audio conference, set for Oct. 12 and Nov. 16, will provide appeal instructions and 25 appeal letter templates covering the most common denial types such as incorrect payment, coding, medical necessity, maximum benefits, eligibility/coordination, timely filing and slow payment. Call 888-399-4925 to sign up for one of the dates.
"Providers may mistakenly think their only protections are those spelled out in the managed care contract. Managed care contracts were written by the carriers. State and federal law go much further in demanding quality appeal review," said Tipton.
The appeal letters discussed during the presentation were developed for AppealLettersOnline.com. AppealLettersOnline.com is the first online appeal letter resource for medical organizations. It features 1600 medical appeals, more than 200 articles and is updated monthly with new appeal information. AppealLettersOnline.com helps thousands of physicians, hospitals and billing professionals recover wrongfully denied money. For those who cannot attend the audio conference, a number of free appeal letter templates and articles are available at AppealLettersOnline.com.
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Contact: Tammy Tipton, President
Appeal Solutions, Inc.
888-399-4925 ext 703
SOURCE Appeal Solutions Inc.