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  • Writing Effective Appeals for Orthopedic Denials

  • Hosted By:
  • ComplianceOnline
  • Start:
  • Thursday - Jun 20, 2013 10:00 AM
  • End Time:
  • Thursday - Jun 20, 2013 11:00 AM
  • Location:
  • Online
  • This healthcare training will discuss specific issues related to orthopedic claims, writing effective appeal letters, issues related to modifiers and the follow-up process on appeals. You will learn about common errors in claims processing and how to avoid them.

    Why Should You Attend:

    When insurance carriers have not processed claims according to the guidelines it is essential to have the tools to effectively communicate with the insurance carriers for proper reimbursement. Often insurance carriers claims processing systems do not properly process modifiers used on claims to accurately describe specific situations related to a surgery on a case by case basis.

    This webinar will discuss specific issues related to orthopedic claims and what works in adjudicating payments from the insurance carriers. The orthopedic anatomy will be reviewed for a better understanding of CPT’s intent on the use of many of the most common orthopaedic surgical cases. We will discuss common errors in claims processing and attendees will receive sample appeals letters to utilize in their office for the most frequently received orthopaedic denials. The references that should be used in addition to the appeal will also be shared for more effective appeals. CMS created NCCI Edits and Medically Unlikely Edits will also be described, as many insurance carriers apply these edits to claims processing for proper coding.

    The presenter will provide helpful hints on other tricks to get your appeals noticed, and the process of tracking appeals, based on a proven system currently being used, for efficiency and results.

    Areas Covered in the Webinar:

    - What should be included in an affective appeal letter
    - What documentation should be included in your appeal
    - Tips on what to do when insurance carriers are not recognizing modifiers
    - What reimbursement should be received on add on codes and tools to correspond with insurance carriers
    - Follow up process on appeals
    - Suggestions to track appeals payments
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