Recoup lost time and revenue with denials management and appeals know-how. Claim denials can sink a profit margin. And given the cost of appeals, roughly $118 per claim, not all denials can be reworked. A practice submitting 50 claims a day at an average reimbursement rate of $200 per claim should bring in $10,000 in daily revenue. But if 10% of those claims are denied, and the practice can only appeal one, they lose $800 per day—upwards of $200K annually. Your medical claims are the lifeblood of operations. Don’t compromise your financial health. Learn how to preempt denials with the Denials Management & Appeals Reference Guide. This vital resource will equip you to get ahead of payers by simplifying the leading causes of denials and showing you how to address insufficient documentation, failing to establish medical necessity, coding and billing errors, coverage stipulations, and untimely filing. Rely on AAPC to walk you through the appeal process. We’ll help you establish protocols to avoid an appeals backlog and teach you how to identify and prioritize denials likely to win an appeal. What’s more, you’ll learn when a claim can be “reopened” to fix a problem. Collect the revenue your practice deserves with effective denials and appeals solutions: Know how to analyze your denials Defeat documentation and compliance issues for successful claims success Utilize payer policy for coverage clues Lock in revenue with face-to-face reimbursement guidance Refine efforts to avoid E/M claim denials Ace ICD-10 coding for optimum reimbursement Put an end to modifier confusion Stave off denials with CCI edits advice Navigate the appeals process like a pro And much more!

The Denials Management Training Handbook (Pack of 5) Tanja Twist, MBA/HCM Many hospitals struggle with denials management thanks to the complex regulations and various types of denials. Payers often send denials to the wrong person, and hospitals may lose valuable research and appeals time as a result. In addition, drafting effective appeals letters that follow Medicare's regulations can be time-consuming and difficult even for experienced staff. Worst of all, the hard work of managing denials and submitting appeals on the back end can all be wasted if there is no system to use denials data to address root causes on the front end. The Denials Management Training Handbook provides clear, concise explanations of the complex appeal guidelines for Medicare and other payers. This information is presented in an easy-to-understand handbook for distribution to staff members involved in preventing and handling appeals. This handbook will help you manage the denials management process by: Providing an overview of common denial types and appeal timelines Giving you sample forms and templates Exploring best practices for improving the denials management process throughout the revenue cycle Gliding in the use of denials data to track recurrent denials and address their causes

An astute diagnosis of one of the biggest problems in business Denial is the unconscious determination that a certain reality is too terrible to contemplate, so therefore it cannot be true. We see it everywhere, from the alcoholic who swears he's just a social drinker to the president who declares "mission accomplished" when it isn't. In the business world, countless companies get stuck in denial while their challenges escalate into crises. Harvard Business School professor Richard S. Tedlow tackles two essential questions: Why do sane, smart leaders often refuse to accept the facts that threaten their companies and careers? And how do we find the courage to resist denial when facing new trends, changing markets, and tough new competitors? Tedlow looks at numerous examples of organiza­tions crippled by denial, including Ford in the era of the Model T and Coca-Cola with its abortive attempt to change its formula. He also explores other companies, such as Intel, Johnson & Johnson, and DuPont, that avoided catastrophe by dealing with harsh realities head-on. Tedlow identifies the leadership skills that are essential to spotting the early signs of denial and taking the actions required to overcome it.

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"In this new book, Jared Del Rosso argues that to understand contemporary social problems we need to become aware of the strategies that people use to deny the existence of those very problems. Drawing on research in sociology, criminology, psychology, and communication studies, Del Rosso develops a new vocabulary for describing denial and its consequences. With examples from everyday observations, current events, and social scientific research, Del Rosso also reveals just how widespread and varied the uses of denial are. Some uses of denial can help people repair their interactions and relationships with others. But most uses of it allows problems to fester, unrecognized. We need, Del Rosso concludes, forms of acknowledgement to surface long-denied problems. But more than that, we need collective forms of action to remedy the harms that those problems and our denial of them have done"--