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The Changing of the Code: Quarterly Code Changes May Require Appeal

Are your billing professionals keeping up with NCCI quarterly code changes?  Now is the time to review the NCCI quarterly code change report.

The NCCI code changes went into effect July 1 and include a number of retroactive code changes that allow you to resubmit claims for additional payment . . .

Continue reading this article at AppealLettersOnline.com

AppealLettersOnline.com Featured Letters

Appeal Solutions has the following letter to assist members with requesting retroactive precertification. This letter is useful in situations where the patient did not provide correct information regarding precertification requirements.  Please see the following letters under the topic Stalled Claims:

Coordination/Subrogation - Request for Retroactive Review

We have recently had a number of requests from anesthesiology members for a letter more specific to anesthesiology claims.  Therefore we have posted information at the AppealLettersOnline.com Users Forum regarding lack of precertification of anesthesiology claims.  Please visit the forum if you have suggestions on effective appeals related to anesthesiology precertification or if you wish to view the posted suggestions.

Access the appeal letters at AppealLettersOnline.com

25 Mental Health Appeal Letters and How to Use Them Like a Pro

Appeal Solutions has developed the largest collection of mental health appeal letters available.  These letters are most effective when used by a billing team trained on quality appeal review.

25 Mental Health Appeals Letters & How to Use Them Like A Pro is a three hour presentation which is customized for your practice.  Tammy Tipton, President of Appeal Solutions, will discuss how to assert your rights when insurers deny or underpay mental/nervous health claims.  Level I and Level II appeal responses will be discussed and legal protections related to appeal review will be explained.  Some of the appeal letters to be discussed include the following:

• Incorrect verification of benefits

• State and/or federal laws related to behavioral health including access to care, peer review and compliance with mandatory coverage laws.

• Coding appeals and demanding release of applicable coding criteria.

• Tips to improve medical necessity appeals.

• Getting action on unnecessarily stalled claims.

• Maximum Benefit Appeals and

• Patient Appeal Efforts.

Cost of the presentation is $2500 plus airfare, hotel and transportation expenses to your facility.  Training includes 25 appeal letters customized for your specific denial issues.

Visit AppealSolutions.com for more information or call 888-399-4925.