April 5, 2011

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Measuring Financial Vital Signs: Power of Appeals Reporting Looks at Denial Impact & Performance

Are your organization's financial vital signs hard to measure?  The increasing complexity of medical reimbursement means increasingly complex financial health analysis.

Power of Appeals software is the leader in denial management with its powerful database of 1600 compliance-focused appeal letters. Now, Power of Appeals provides additional financial analysis tools to allow users to achieve better management of a challenging financial variable: denied claims.

Denials hurt healthcare organizations. Dollars lost to denials must be calculated. Appeals must be tracked and overturned denials should be calculated as well. Power of Appeals makes it easy to analyze denials causes, appeal success and ongoing account disposition.

To make denial-related financials easier to review, Power of Appeals now features a Denials Dashboard with at-a-glance monitoring of Denials Aging and Denial Recovery. The Dashboard also allows you to quickly assess how your organization stands on Denials By Payer Group, Denials by Denial Type and Denials By Carrier.

Power of Appeals has also made a number of improvements to the software's Reporting and Analysis feature.  A number of Standard Reports give you the most valuable denial management data.  New Standard Reports allow you to perform the following activities with a goal-setting and measurement focus:

Day-to-Day Management Review Reports, End-of-Month Performance Reports, User Performance Review, Payer Performance Review, Problem-Focuses Analysis

Keep in mind, Power of Appeals allows you to configure your own reports and retain new report formats under Memorized Reports. However, the Standard Reports display the information most frequently used in denial management and gives you quick access to important account information. Here are some of the specific reports available in Power of Appeals:

Day-to-Day Management Review:  Priority Reports, Analysis By Claim Status with Aging Detail
End of Month Performance Review (AR, Recovery Reports):  Analysis By Account Status, Analysis By Payer Group, Recovery Report By Payer Group
User Performance Review (Employee Performance Review):  Analysis By User, Recovery Analysis By User With Aging Detail, Analysis By User Priority Status - Review Write Off
Payer Performance Review:  Recovery Report By Payer , Analysis by Payer, Denial Type By Payer
Problem-Focused Analysis:  Analysis By Claim Status, Analysis By Denial Type, Account Review - High Balance, Account Review - Incorrect Contractual Denial Type, Account Review - Medical Necessity Denial Type, Recovery Report By Denial Type

Visit www.PowerofAppeals.com for software pricing and features


AppealLettersOnline.com Featured Appeal Letters

AppealLettersOnline.com has a number of letters related to lack of precertification.  See the category Medical Necessity for letters to assist you appeal based on clinical issues related to this type of denial.  A lack of preauthorization denial can also result from Coordination of Benefits issues. AppealLettersOnline.com has a letter for requesting retroactive precertification for situations where the primary coverage was unknown at the time of treatment.  See Stalled Claims and the subcategory, Coordination of Benefits for the following letter:

Request for Retroactive Precert/Authorization

This letter could be customized to make other explanations why a precert was not obtained (recent change in carrier policy, change in surgical procedure mid surgery from something not requiring precert to procedure requiring precert).  This letter also helps clarify the ramifications of lack of precertification in case you are unable to determine the patient liability.

Access these appeal letters at AppealLettersOnline.com


FREE WEBINAR!  Maximize Your Reimbursement: How to Identify Hidden Denials And Write Appeal Letters That Work

Most practices diligently track denied claims because of the impact they have on revenue; however, there are other types of denials - hidden ones - that often fly under the radar while slowly draining revenue.  In this complimentary webinar, sponsored by Navicure and Appeal Solutions, learn how to maximum your reimbursement by identifying and tracking these "hidden denials".

Join us on Wednesday, April 20 at 1:00 pm EDT, for a free webinar: Hidden Denials and Appeal Letters: Tips and Tricks to Maximizing Your Reimbursement.

During this hour, you'll hear industry expert, Tammy Tipton, president of Appeals Solutions, discuss:

  • The Hidden Denial Effect, what types of claims to scrutinize and how to detect revenue lost to hidden denials.

  • Tactics to identify payer-specific "hidden denials" and tips for dealing with payers lack of compliance with standard coding rules and guidelines.

  • Best practices for writing winning appeals letters, including what to demand, how to protect your right to a quality appeal review and key appeal components which guarantee a more thorough review and response from the payer.

Participants can earn 1.0 Continuing Education Unit (CEU) from the American Academy of Professional Coders (AAPC) by attending.

Complete information and registration is at: Free Appeals Webinar for CEU Credits.

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