If you are as enthusiastic about medical billing and reimbursement, it can be vexing when we receive a denial. Here are some tried and true points that every biller should know to address a true appeal correctly. Know Your Coding In today’s multitasking office you will often find billers who are certified in both collections […]
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Tag Archives: Appeals
The Job of an Appeals Analyst
By Kimberly Hartley, CPC, AAPC Fellow You billed the insurance company for a service provided by your office only to receive a denial remittance. Is the denial valid? Why wasn’t the claim paid? Who can review the explanation of benefits summary and make a determination? Enter the appeals analyst — an essential position for physician […]
AAPC Knowledge Center
Appeals
How would one go about filing an appeal for an expired surgery auth for said surgery done three days later?
Peace
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This is for an ongoing DOL claim.
Baylor Scott & White Appeals
Hiya, Community! Can you help me?
I have a friend at a HIPAA-/PHI-compliant business associate company who is seeking a better way to contact the appeals department at Baylor Scott & White (BSW) Health Plan. It is for an oral (po) medication FDA-indicated for rheumatology and dermatology.
Does anyone have a phone number or email for oral-med claims at BSW?
I would appreciate any guidance you can provide me!
Baylor Scott & White Appeals
Hiya, Community! Can you help me?
I have a friend at a HIPAA-/PHI-compliant business associate company who is seeking a better way to contact the appeals department at Baylor Scott & White (BSW) Health Plan. It is for an oral (po) medication FDA-indicated for rheumatology and dermatology.
Does anyone have a phone number or email for oral-med claims at BSW?
I would appreciate any help you can provide!
Medicare Managed Care Appeals & Grievances
Time Limits Matter for Claim Appeals
Provider agreements (or the ancillary documents) outline the formal processes to appeal payers’ payment decisions. You must review your agreement (or ancillary documents) with the specific payer to comply with the rules of the appeal process. A meritorious appeal may fail because you didn’t meet deadlines, follow the outlined procedures, or provide the necessary information. […]
AAPC Blog