Denials and Appeals

Use this sample form as a guide for a manager of denials management job description.

Use this sample form as a guide for an appeals specialist job description.

Use this sample form as a guide for notifying doctors of a Medicare inpatient to outpatient change.

Use this sample form as a guide for notifying patients of a Medicare outpatient status change.

Use this sample letter to notify patients of a post-discharge self-denial by the utilization review committee.

This document provides guidance on key performance indicators for denials management and revenue integrity, including calculations for denials rates and denials overturn ratios.