Denials and Appeals

Prepare to meet the future.

Learn how to integrate physician advisors into revenue integrity programs.

Q: How do you handle clinical validation denials when payers say you won’t receive payment unless you remove a code from the claim? 

While communication is key to reducing denials, it’s very difficult to do well, according to Nancy Blattberg-Smith, MPH, RHIA, CDIP, CCS,

After receiving negative feedback from industry stakeholders on its new reimbursement approach for certain inpatient Medicare Advantage (MA) claims, Aetna recently extended the policy’s implementation date.

Review the latest claims processing instructions from CMS for telehealth and acute hospital care at home services.

Sourcing field-tested, reliable denials management processes is not a simple task.