The ABC’s of Appeal Letter Writing for the SNF

Event Information
Product Format
Prerecorded Event
Elisa Bovee, MS, OTR/L
Conference Date
Tue, Aug 25, 2015
60 minutes
Product Description

Learn the Strategies for Interdisciplinary Management of Medicare Denied Claim Appeals


There has been a considerable increase in Medicare Part A Additional Documentation requests (ADRs) and denials in skilled nursing facilities. The purpose of medical review is to determine whether the services are reasonable and necessary, delivered in the appropriate setting, and coded correctly, based on appropriate documentation.

Expert speaker Elisa Bovee, MS, OTR/L will begin this session by discussing recent national trends in Medical Review. The presentation will culminate in a review of the keys to responding to a Medicare denied claims with appeal tips and strategies. Additionally, you will be able to summarize goals of Medicare Medical Reviews, identify and articulate examples of the Appeal letter statements, and learn the strategies for interdisciplinary management of Medicare denied claim appeals.

Session Highlights:

  • Know what triggers Additional Documentation Requests (ADRs).  How can you educate the team to avoid causing triggers?
  • Are you ready?  How can your facility thoroughly and timely manage the appeal process?
  • Don’t make avoidable mistakes!  Structure appeal statements to get claims paid
  • Write a letter that outlines the justification for payment.  Learn what vital details to include
  • Solve a case study with your team

Who should attend

CEOs, CFOs, Administrators, Nursing Management, Nursing Staff, Therapy Management, Occupational Therapists, Physical Therapists, Speech Pathologists and Business Office Managers


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About Our Speaker

Elisa Bovee - Medicare Billing Expert

Elisa Bovee, MS, OTR/L, is the Senior Vice President of Operations for Harmony Healthcare International, a nationally recognized, premier Healthcare Consulting firm specializing in C.A.R.E. (Compliance, Audits and Analysis, Reimbursement and Regulations, Education and Efficiency). In her role, Elisa manages a diversified team of HealthCARE Specialists who have extensive knowledge in the areas of Corporate Compliance, MDS 3.0, RUG-IV, Documentation, Therapy Program development and state-specific Medicaid Case Mix. Elisa...   More Info
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