There are three words that cause a myriad of headaches for many staff members - appeals, denials and adjustments. I mean wouldn't we all love to live in a world where claims were billed correctly the first time and insurance companies paid the first time? This would of course be the land of those horses with horns on their heads; you know the ones, unicorns.
Poor jokes aside, the reality is that we don't always get the claims right the first time and most certainly we all know that insurance companies don't like to pay anything that they don't have to (and some could argue that they don't like to pay what they have to as well!) and this is where those three (hated) words come into play and as a result this book comes in.
Written by mother and daughter team Alice Scott and Michele Redmond it covers the gamut of denials, appeals and adjustments in an easy-to-read, conversational manner. By providing information through examples and situations that they have faced in their own billing business you're bound to find answers for any and all situations that you'll ever encounter.
38 chapters are covered in this book and include Ammunition for an Appeal, Writing a Formal Appeal, Requested Medical Notes or Documentation, Maxed Benefits, Procedure Included with Another Service, Multiple Match for Auth, Services Not Covered for this Diagnosis, Uncommon Denials, Medicare Denials and Cutting Down on Denials. There is also a link to a pdf file that provides you with sample forms that you can use in your daily role.
So if you're having some troubles getting your claims paid and are buckling under the weight of denials. appeals and adjustments then this is a great resource for you to have and refer to. And remember, Alice is happy to receive your comments and has provided a link to their forums where many topics such as this and others are covered.
Check out the other books that Alice and Michele have written as well. Topics covered include Basics of Medical Billing, How to Start Your Own Medical Billing Business, 12 Marketing Strategies to Grow Your Medical Billing Business, Secrets to Signing Up Your First Doctor, Mental Health Billing Made Easy, Pricing Your Medical Billing Service and many more.