Articles Tagged With: appeals
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Denial Prevention Tactics Are Front End-Focused
Revenue cycle departments spend lots of time and money appealing denied claims. However, some hospitals are diverting resources to the front end instead. -
Denials Categorized Based on Complexity
Some denials can be overturned easily — maybe a piece of clinical documentation is missing. Other denials are a long shot, requiring lots of time and effort to challenge. For one Philadelphia-based health system, no mountain is too high to climb.
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Lessons Learned from Overturned $4.3 Million HIPAA Penalty
A covered entity’s victory over proposed penalties from the Department of Health and Human Services was good news for those responsible for HIPAA compliance, showing that good faith efforts and a willingness to fight the allegations can pay off.
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Court Orders New Trial Over Hospital’s Improper Closing Arguments
The appellate court’s decision focused on whether the non-party status of the nurse who allegedly dropped plaintiff was determinative in the case at hand. The court of appeals found the trial court failed to exercise its full range of discretion and had not carefully considered the fact that although the nurse was not a party to the case, her conduct was the object of the case, and it was unclear whether the jury fully understood that she was not a party to the matter.
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‘Uncollectible’ Claims Just Need Fresh Approach
Stat diagnostic tests are triggering claims denials because payers dispute the urgency. This article discusses steps patient access can take to increase the chance of a successful appeal.
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Certified Registered Nurse Anesthetist Sues Hospital For Suspension Related to Suicidal Comments
When do an employee’s personal troubles threaten patient safety and justify limiting work duties? A certified registered nurse anesthetist recently sued a hospital after it put her on sick leave and demanded a psychiatrist approve her return to work, which was prompted by her statements suggesting suicidal thoughts and the concerns voiced by her coworkers.