A P R I L 2 0 1 6 • O U T PA T I E N TS U R G E R Y. N E T • 3 5
and gather previous documents and records to support your argu-
ment. It's also a good idea to demand the insurer show you proof
backing up their claims.
Appealing refund requests can take a lot of time and energy, and the
best way to enhance your chances of success is to ensure you and
your staffers are properly trained on how to assess the validity of
claim determinations. There are many resources available, including
webinars and other related denial management training courses
addressing advanced appeal rights and processes. No matter what
action you take, don't just roll over when insurers come with recoup-
ment requests — take a stand and protect the revenue you are enti-
tled to receive.
OSM
Ms. Dittrich (medrevenue@bellsouth.net) is a claims recovery and
ERISA/PPACA appeals specialist for MedRevenue Solutions.