Home | Download Library Download Library This is the area we store an assortment of files and documents which you can download and use. To use these files, you'll first have to download them onto your computer, and then open them.

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DOWNLOAD: Sample Letter for Requesting Managed Care Contract Renegotiation This document includes a sample letter supporting your request to renegotiate a Managed Care contract. The development of a mutually beneficial working relationship that fosters problem-solving, formalizes respective duties through clear, mutually beneficial contract terms, and encourages open, ongoing communication is critical to the success of every healthcare organization. . . .Download >> DOWNLOAD: Notification of Claim Negotiation With Third Party Repricing Company Notification of claim negotiation with third party repricing company sample letter. . . . Download >> DOWNLOAD: Appeal Letter Attachment Documentation This document is a complete list of the different types of documentation that can be included in your letters to make an appeal more persuasive as well as some explanatory information on how to ensure complete review of the documentation submitted. . . .Download >> DOWNLOAD: Tracking Memos for Utilization Review/Case Management Department Use these tracking memos to follow up on requests that don't result in an immediate response. The tracking memos provide the patient-specific information and date and time of the request, and should quote regulatory information regarding necessity of response. . . . Download >> SLIDESHOW: 5 Sentences to Improve Your Appeal Letters Do your carefully worded appeals result in simple form letter responses? If so, it is likely that your appeals may need more forceful language regarding carrier appeal review and response requirements. Getting the insurance carrier to provide a customized detailed response starts with making appeal letters more specific in regard to the appeal review and response requirements. . . . Download >>

DOWNLOAD: Power of Appeals Denial Management Software Demo Download a trial version of our Power of Appeals Denial Management software application that improves cash flow and reduces write-offs by analyzing denials, streamlining denial appeals, tracking the disposition of denial appeals and providing denial prevention reporting and analysis. . . .Download >> DOWNLOAD: Fee Schedule Renegotiation Request Letter This Fee Schedule Renegotiation Request letter easily initiates negotiations for fee schedule increases to offset ongoing investments in quality improvements. The letter provides some suggested wording which medical organizations can use to inform payers about quality of care initiatives and the need for fee schedule adjustments related to these efforts. . . .Download >> PODCAST: An Interview with D. Brian Hufford on Contesting Carrier Recoupment Mr. Hufford of Pomerantz, Haudek, Grossman & Gross law firm speaks about the recoupment litigation involving BCBSRI and also references related litigation involving Aetna and United Healthcare. Hear his instructions on contesting recoupment efforts and also additional discussion regarding how class action litigation is being used to represent the large number of involved providers. . . . Download >> PODCAST: An Interview with Attorney Jennifer Jaff on 1,000 Page Appeal Letters and Overturning Experimental/Investigational Denials Attorney Jennifer Jaff, with the Advocacy For Patients With Chronic Illness, speaks about appealing and overturning Experimental/Investigational denials. . . . Download >> DOWNLOAD: Audit Results Information Request Letter This Audit Results Information Request Letter can assist your organization with requesting additional information related to overpayment recovery audit results. . . .Download >>

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