eNewsletter: Reimbursement eNewsletter for the healthcare community

ISSUE 47 January 8, 2008










Appeals & Denial Avoidance Training
Appeal Solutions has developed an onsite appeal training program for organizations that want to take control of denial management in 2008. Tammy Tipton, President of Appeal Solutions and author of HCPro's "Appeals Toolkit," has developed a comprehensive training program designed to assist medical providers with appeals, prior authorization techniques and contract negotiation.
Read more about this training program...
Negotiate a Better Managed Care Contract
The beginning of a new year is an excellent time to assess your need to strengthen your managed care contract agreements. Healthcare billing personnel often begin to view the provider–carrier relationship as an adversarial, often dysfunctional partnership, and improving that relationship may be low on a long priority list of urgent action items.  However, 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, especially those that are operating in areas where they can simply be dropped from their high-volume plans. read this full article
AppealLettersOnline Featured Letters
Carriers frequently renew contracts automatically on a yearly basis without initiating a discussion of the contract terms. has added a letter for you to use to request contract renegotiation. This letter notifies the carriers that you wish to review payer claim processing performance and discuss updates to fee schedule allowances and contractual protections. This letter can be easily customized to highlight specific areas of concern so that the payer representative will be prepared to discuss the topics of greatest impact to your office or facility. The new letter can be downloaded in the "Managed Care" section. 
Sign up to access this letter
Medical Appeals Audioconference:
Train your entire staff on appealing denied and incorrectly paid claims with our 90-minute audioconference featuring information on asserting your rights when insurers deny or underpay your claims.  This conference will be held March 4th and includes 50 proven appeal letters.  Registration is limited.  Call 888-399-4925 or click here for details