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O U T P A T I E N T S U R G E R Y M A G A Z I N E O N L I N E | O C T O B E R 2 0 1 5
Fight Back Against Rejected Claims
6 tips for turning claim denials into revenue.
A
ppealing
rejected
claims
doesn't seem worth
the hassle some-
times, does it? But
having a timely,
organized and well-
documented process
not only helps you
recoup costs for
services, it is also
vital if litigation aris-
es. While the exact
steps vary depending
on whether you're an
in-network provider
and in which state
you reside, these tips
should improve your
chances of turning a claims denial into payment.
Review your assignment of benefits
In general, the success of your appeal depends on how good
your documents are. If a good record exists of the services and sup-
plies used, as well as all contact made between the insurer, facility
and patient, it makes appeals — and litigation — that much easier.
Good documentation is the most important thing in an effective
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C O D I N G & B I L L I N G
Elizabeth Lemoine, JD
z APPEALING RESULTS When a payer rejects
your claim, what's the best way to get paid?