Audioconference Title: 2 Appeals Are Better Than One: Helping Your Patients Submit Winning Appeals
Audioconference Objective: This presentation will cover how to improve your patient advocacy skills by developing a few basic appeal letters for your patients to use to initiate appeals.
Audioconference Date: October 13, 2011
What happens when patients receive health claim denial letters?
Does their blood pressure go up? Do they feel defeated and overwhelmed?
Do they call the insurance carrier? Or, more likely, do they call their trusted caregiver for assistance with this denied claim?
Patients typically seek guidance from providers on resolving insurance issues. Some are motivated and ready to appeal. Some are confused. Some are angry. Your response will have a dramatic impact on patient appeal success and their understanding of both the denial and their rights. However, your lack of response may leave them feeling alone and unable to tackle this new challenge.
Tammy Tipton, President of Appeal Solutions, will cover how to improve your patient advocacy skills in the upcoming audioconference Two Appeals Are Better Than One: Helping Patients Submit Appeals on Oct. 13th. The most obvious way to help patient with appeals, according to Tipton, is to develop a few basic appeal letters for your patients to use to initiate appeals. However, sample appeal letters should not be distributed without providing the guidance necessary to use the letters with confidence. During this 90-minute audioconference, Tipton will go over the following patient advocacy appeal steps designed to create a partnership between patient and provider through the appeal process:
Walk the patient through how to review plan or policy documents for appeal filing instructions and important applicable terms. In particular, make sure they understand that there may be timely appeal filing requirements and untimely appeals may be denied.
Provide a sample appeal letter and explain basic consumer protections related to patient appeal review.
Explain the importance of appeal documentation. Do your part! Facilitate any necessary documentation request on a “rush” basis to convey how important appeal documentation is to appeal success.
Ask the patient to fax or email you a copy of the final appeal. Why? Let them know what you’ll be doing to confirm receipt by the insurer, request a timely response to the appeal and coordinate your own appeal efforts, if any, with the patient appeal efforts.
Explain that if the insurer fails to respond in a professional manner that the patient has other avenues, such as higher level appeal review, seeking an external review or filing a complaint with the state insurance department or other authority. This is the critical step and we will talk about how, when and why higher level appeals fall flat without a good provider advocacy skills.
Participants in the audioconference will receive ten sample patient appeals which your organization can use as a starting point to developing your own patient appeal letter package. Not available on the audio conference date? Get the Two Appeals Are Better Than One: Helping Patient Submit Appeals audioconference recording for the same price.