Medical Denial & Appeal Services: Confronting Denials

<body> <h1>Don't Take "No" For an Answer: Medical Denial & Appeal Services</h1> <p><a href="medicalappeals.htm" target="_top">Medical Denial Problems?</a> | <a href="appeal_confront.htm" target="_top">Confronting Denials Head On</a> | <a href="appeal_win.htm" target="_top">Challenge We Can Win</a></p> <p>Chapin Revenue Cycle Management can recover revenues lost to medical denials. Our clinicians and denial specialists have worked as both payors and providers. They are keenly aware of different payor authorization and appeal processes and understand the clinical guidelines. Chapin is a licensed InterQual Review Agency, and so our on-staff RNs have a working knowledge of the medical criteria and protocols necessary to make the case for a successful appeal. Chapin nurses have the background and experience needed to write appeals letters that lead to recovered revenue. We understand the appropriate course to take that will result in payment, whether it involves proving medical necessity, or overcoming procedural roadblocks. If the initial appeal for a medical necessity denial isn’t successful, Chapin will prepare second and third-level appeals and/or, with your permission, pursue arbitration in necessary to secure your payment.</p> <h1> Confronting Denials Head On</h1> <p> While it is ideal to handle medical denials as they happen, Chapin can also go back into your past records and find denied claims that are still recoverable. In either case, our appeals process begins by scanning medical records for the denied claim to a secure electronic media file. The HIPAA-focused policies, procedures and safeguards Chapin has built into its technology and operations ensure the confidentiality and privacy of your patients and their protected health information. A Chapin RN will review each case and write the appropriate appeal letter. </p> <p>When necessary, we will work with you and your medical staff to expedite payment. For example, consider the case of “a physician-ordered admission” where a pre-certification or re-certification for an extended stay was not obtained by hospital staff and the medical records are insufficient to prove necessity. With your permission, we will contact the physician for assistance with clarifying the decision to admit. We will then send the appeal letter via certified mail with the appropriate documentation and support to the payor. Chapin will then follow the appeal until it is resolved. As our fees are contingency-based, we are compensated only when we recover money for you. </p> <h1>A Focus on Prevention</h1> <p> With evidence showing that 90 percent of denials are preventable through improved execution of verification, authorization and clinical documentation efforts, it’s clear that preventive measures offer the best long-term strategy for recovering denied revenue. Furthermore, significant recovery costs can be avoided altogether through effective denial prevention efforts. The data we develop through assisting you with your current or historical medical denials will support your focus on prevention. Our customized reporting allows you to identify problem areas by denial reasons, diagnosis, physician, payors and procedures. We can help you use this information to prevent these denials from recurring in the future. </p> <p><a href="appeal_win.htm" target="_top">A Challenge We Can Win Together</a> </p> <p>Let us help you recover what's missing from your bottom line. For further information about Chapin's customized solutions, contact Rick LaForge (<a class="menu" href="mailto:rlaforge@chapinrcm.com">rlaforge@chapinrcm.com</a>). </p> <p><a href="ChapinRCM.htm">Chapin RCM Home</a> | <a href="auditrecovery.htm">Audit & Recovery Services</a> | <a href="accountsreceivable.htm" target="_top">Account Receivable Services</a> | <a href="medicalappeals.htm" target="_top">Medical Denial & Appeal Services</a> | <a href="chapin.htm" target="_top">About Chapin</a> | <a href="experts.htm" target="_top">Experts</a> | <a href="privacy.htm" target="_top">Privacy</a> | <a href="contact.htm" target="_top">Contact Chapin Revenue Cycle Management</a> </p> </body>