May 10, 2011

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Insurers Say Sub-Specialty Peer Reviewers Are In Short Supply

Access to sub-specialty peer reviewers is one of the most important protections related to quality appeal decisions. Yet recent insurance industry comments related to healthcare reform indicate that sub-specialty peer reviewers can be difficult to arrange within the appeal review time constraints and may result in review by a poorly qualified reviewer. . . .

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AppealLettersOnline.com Featured Appeal Letters

Appeal Solutions has a number of appeal letters which can be easily customized for specialty and sub-specialty appeals.  Please see the Topic: Specialty Care Appeal Review.  The following letters are specific to peer review requests:

Request for Retroactive Precert/Authorization
Request for Anesthesiology Peer Review
Request for Cardiology Peer Review
Request for Gastroenterology Peer Review
Request for Neurology Peer Review
Request for Ob-Gyn Peer Review
Request for Oncology Peer Review
Request for Orthopedic Peer Review
Request for Pediatric Peer Review

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. 

Our free webinar, “Hidden Denials and Appeal Letters: Tips and Tricks to Maximizing Your Reimbursement,” is now available for download. During this hour long webinar, Tammy Tipton, president of Appeals Solutions, explains:

  • 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 listening and successfully competing the webinar post test for continuing education units.  Register and Download the webinar here.

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