tci Part B Insider - 2019 Issue 1

Appeals: Thoroughly Investigate Your Denials with These Expert Tips

Hint: Back up your claims with solid evidence. Maybe you’ve always wanted to do some private investigation work, or perhaps you enjoy watching sleuthing shows on television — either way, you can put these skills to the test if you have some denials on your desk. By being the lead investigator of your own appeals process, you can find the reasons behind your denials and hopefully reverse them. Review Remark Codes It’s easy to miscommunicate if you’re speaking a different language. Make sure you understand exactly what a payer requires — and then format your appeal...

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