tci Outpatient Facility Coding Alert - 2015 Issue 5

Reimbursement: Deal With Your Denials in the Right Way

Understand the different level of appeals and prepare your claims! You don’t need to fret over denied claims anymore. Read the denials and know what they mean so you can file an educated appeal. If you are unsure how to do this, reach out to the payers for help. Know How to Go Up the Appeals Ladder There are five levels of appeals for Medicare denials, Affordable Care Act (ACA) says. Understanding how these levels build on each other is your first step toward understanding the appeals process.  Level 1: Redetermination: You can submit the appeal with...

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