Audioconference Title: 25 Appeal Letters And Using PPACA For Today’s Appeals
Audioconference Objective: Presentation and Review of 25 Medical Appeal Letters which are designed to easily appeal most common denials and demand a detailed, PPACA-compliant response from insurers regarding nonpayment. Letter collection has been updated to include many ERISA and PPACA (Patient Protections and Affordable Care Act) protections. Proven Strategies for Level II appeal customizations, denial prevention and what to do when appeal efforts fail will also be discussed.
It’s a fact: A well-written appeal is your most effective tool for challenging an insurance claim denial. In this audio conference, presenter Tammy Tipton will provide 25 of Appeal Solutions’ most effective Level I and Level II Appeal Letters and share the strategies to make these appeal letters collect on unfair denials.
A nationally-recognized authority on this topic, Ms. Tipton will explain, clearly and concisely, specific tactics for selecting and preparing the right appeal letter for a wide range of denials. She will also assist participants with understanding their legal rights under the recently enacted PPACA and how to argue those rights effectively when carriers uphold denials unfairly.
You’ll gain indispensable insights into:
Winning the reimbursement war by using the 25 Level I and Level II Appeal Letters provided during the audioconference. Letters provided will cover Lack of Medical Necessity, Coding, Lack of Preauthorization, Lack of Timely Filing, Maximum Benefits Reached, Preexisting Conditions, Refund/Recoupment, Coordination, and Stalled Claims. Information will be provided on making easy customizations to the letters to make them appropriate for even more denials
Timely appeal submission and how our Level I letters enable you to consistently meet appeal submission deadlines
Asserting your rights with insurers including your right to demand and review the carrier’s internal rules and guidelines used to reach the adverse determination
Selecting the most appropriate letter for each appeal and determining which state and/or federal laws to know and use for each type of appeal
Using state and federal laws to overturn benefit reductions and receive full payment
Seven tips to improving medical necessity denials with the help of Appeal Solutions’ Level I Medical Necessity Appeal Letters.
Getting a move on stalled claims by citing regulatory information
Strengthening your appeals in cases involving an insurance carrier’s incorrect verification of benefits
Obtaining detailed responses to your appeals – instead of those frustrating form letters