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Winning Appeals With A Little Less Paper

20 Apr 2015, Posted by Stacie Van Der Bosch in Uncategorized

As a remote employee, I’ve gotten quite good about the whole paperless routine—

I don’t even own a printer anymore.

Because when you think about it, almost everything can be done online these days; even faxes can be sent and received through your email or a web-based software. And it’s all true for the appeals process, too, which has become both simpler and more efficient as it’s transitioned to paperless. Here’s how (and why).

Don’t Start with An Appeal
Sometimes, the most effective appeal actually begins with a request for reconsideration, which is exactly what it sounds like. This is always my starting point and my request is granted at least half the time, making an appeal unnecessary.
The trick is making sure to start with this request. If you start with an appeal, you can’t go back and say, “Actually, can I just ask for your reconsideration on this claim?” But if you start with the reconsideration request and it’s denied, you can still move on to the regular appeal process.

For help with this process, take a look at your carrier’s provider manual (they all have one, and it can usually be downloaded from their site). I realize no one wants to read a manual, but you should really have one for each of your carriers.

Manage Appeals Through the Carrier Website
Most major insurance carriers have secure online portals built specifically for managing appeals and they’re accessible only to business offices and healthcare centers with login credentials. Inside the portal, you can complete and submit appeals documentation (often with carrier-specific information auto-completed for you), upload letters or supporting documents and track the progress of each appeal you’ve submitted.

Even if you’re working with a smaller carrier that doesn’t operate a portal, they probably accept appeals via fax. And as we’ve already established, faxing can be a paperless pursuit, too.

Take Advantage of Your Clearinghouse’s Paperless Processes
If you can’t access a portal or found the rare carrier that won’t accept faxes, remember that clearinghouses can aid your paperless efforts, too. Rather than print, stamp and mail a claim from your office, you can code it in a way that signals the clearinghouse to print and mail it on your behalf. The clearinghouse will even work with you to edit or correct claims digitally before they drop it to paper.

Yes, Paperless Appeals Are Worth It
There are three key benefits to managing your appeals without the paper hassle, the first being that you’ll save a lot of money. No paper, no stamps, no envelopes, no ink—you’ll see that add up quickly.

Second, you’ll save time. When claims and appeals are sent and received quickly, they’re resolved quickly, which means accounts are less likely to sit around in A/R.

Finally, when you submit appeals through a carrier portal or via fax, you have immediate proof that it was sent. And when working inside a portal, a confirmation email lets you know that your appeal was received.

Handling the appeals process digitally makes the entire process simpler, faster and more efficient overall.

Still not entirely sure how to make it work for you?

Contact Tracey Erbert, 913.344.7002 for guidance in going paperless and winning the appeals process.

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