How to Draft an Effective Appeal Letter

Event Information
Product Format
Prerecorded Event
Conference Date
Thu, Feb 07, 2019
60 minutes
Product Description

Make 2019 the Year Your Office Maximizes Revenue—and Minimizes Claims Errors

If your office regularly suffers from claims denials due to coding issues or lack of medical necessity, you’re not alone. Whether you’re an in-network or out-of-network provider, there is something you can do to recoup.

Join Thomas J. Force in this how-to session to learn to draft an appeal letter that will get results. The key, of course, is to understand why your claim was denied in the first place, so that you can provide the necessary evidence to demonstrate your right to payment.

As an attorney and owner of a medical billing company for many years, Force comes equipped to deliver several real-world methods that do (and don’t) work to recapture payment after an initial denial. Force will also teach you to interpret plan terms and Explanation of Benefits documents.

You’ll walk away with the tools you need to understand why a claim was denied and then collect and submit the documentation required to make a successful appeal. Force will explain how and when to make a second appeal, if necessary—and how to appeal not just no-pay claims but low-pay claims as well.

Session Highlights

In this course, you will learn to:

  • Understand why a claim was denied
  • Know your appeal rights
  • Identify the documentation needed to file a successful appeal
  • Capture payment on claims denied due to lack of medical necessity
  • Capture payment on claims denied due to coding issues
  • Capture payment on claims denied due to gap exception issues
  • Capture payment on low-pay claims (e.g., Medicare low R&C percentage)

Who Should Attend

This program is designed for in-network and out-of-network providers, physicians, and staff members.

Following the live presentation, the instructor will conduct a Q&A period during which you may ask questions and solicit solutions for your unique situation.

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About Our Speaker

Thomas Force - Compliance Coding Expert

Thomas J. Force, Esq. is a licensed attorney since 1994 in both state and federal courts in New Jersey and New York, with 27 years of experience in the healthcare and insurance industries. He is the president and founder of The Patriot Group, a full-service healthcare physician advocacy and revenue recovery company providing billing, appeals, collections and follow-up services for healthcare. Thomas is also the former CEO, general counsel and...   More Info
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