tci ED Coding & Reimbursement Alert - 2019 Issue Q4

Reader Question: Follow These Tips for Audit Success

Question: We had an outside consultant come in and review our ED claims. He pointed out several that were paid incorrectly and advised us to appeal. We have never appealed before. What do we need to include on the appeals? Florida Subscriber Answer: You should contact your insurer to get the scoop on its preferred appeal process. However, in general, you should make sure your appeal letter references the initial claim. Although this sounds like a basic step, many providers forget to cite the claim number of the claim they are appealing, making it impossible for the insurer to...

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