Author Topic: Appeals Process  (Read 1064 times)

johmarcel

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Appeals Process
« on: February 19, 2010, 12:24:58 PM »
I was just hired to go thru some commercial claims for a small company that does hospice care at homes and hospitals that were not paid from 2008 to 2009. I have not done too many appeals since 2005. I have come across denials from UHC for no notification for hospice care, and another for timely filing.
I do have some correspondences, and the electronic claim acceptance report for these files, my question is what is the best way to get these appeals paid, and how should I create my appeal letter not just for this insurance but other commercial carriers as well?

Michele

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Re: Appeals Process
« Reply #1 on: February 21, 2010, 07:26:46 PM »
That will be hard, but you could do one generic adjustment form indicating the most common reasons for appealing, then just check it off.  The problem is some carriers have their own adjustment forms that they require.

Good luck!

Michele
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