NAHRI Quarterly Call January 30, 2018

Tue, 01/30/2018 - 16:01
Quarterly Calls
Coding and Documentation, Compliance, Denials and Appeals, Policies and Procedures, Revenue Integrity

Addressing complex commercial denials with a clinical perspective

Fri, 01/19/2018 - 10:58
White Papers
Compliance, Denials and Appeals, Program Management, Revenue Integrity

Optum Logo...

Board member insights : Using resources to educate your clinical staff

Wed, 11/15/2017
Revenue Integrity Insider
Denials and Appeals, Revenue Integrity

I believe that avoiding denials in the first place is the way to utilize our revenue cycle resources, especially our human resources. The more times we have to touch or rework a claim, the lower the value our final reimbursement becomes. Our goal is to get it right the first time. This can best be accomplished by education with our clinical staff in a way that they can relate and understand the general coding and billing concepts. 

Complex case: Abrupt change in patient status leads to appeal

Fri, 10/20/2017
NAHRI Journal - Volume 1, Issue 4
Denials and Appeals, Revenue Integrity

Learn how to take a denial through the appeals process in this complex case.

The golden rules for commercial denial prevention and maintenance

Fri, 10/20/2017
NAHRI Journal - Volume 1, Issue 4
Denials and Appeals, Revenue Integrity

Learn tips for denial prevention and maintenance at your facility.

Manager of denials management job description

Thu, 09/14/2017 - 15:09
Job Descriptions
Denials and Appeals, Revenue Integrity

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

Appeals specialist job description

Thu, 09/14/2017 - 15:07
Job Descriptions
Denials and Appeals, Revenue Integrity

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

Condition code 44 letter to doctor

Fri, 08/04/2017 - 09:43
Policies & Procedures
Denials and Appeals

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

Self-denied admission notification letter to patient

Fri, 07/28/2017 - 09:11
Policies & Procedures
Denials and Appeals

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

Post-discharge self-denial letter to doctor

Fri, 07/28/2017 - 09:06
Policies & Procedures
Denials and Appeals, Policies and Procedures

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

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