DecisionHealth, DecisionHealth - 2021 Issue 10 (October)

Add similar services to reach the amount in controversy for appeals

Include a review of the amount in controversy (AIC) during your next training session for staff that works denials. Meeting the AIC is the only way to reach the third and fifth levels of appeal. Note that getting to the right amount isn’t as straightforward as adding up all the claims for a specific service that was denied for the same reason.

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