Writing Effective Appeal Letters:
Tips from Clinical Experts
Writing Effective Appeal Letters: Tips from Clinical Experts
Annual claim denial rates are astronomically high this year, and tackling this influx of denials is going to be the number one priority for RCM leaders going into 2024.
While there’s no quick fix when it comes to appealing denials from payers, health systems know that writing an effective, detailed, and compelling appeal letter is critical for the best chance of a positive financial return.
However, taking the time to gather the evidence and formulate an effective appeal can be outside of the capacity of resources for the health system or hospital, so taking the loss after the appeal deadline has become far too common. Advent recognizes the potential of recovered revenue from appeal letters and has created software dedicated to easing the time and cognitive burden on your organization’s clinical staff.
The Advent Health Partners internal clinical team has more than 15+ years of clinical review experience – let us help your internal team write more effective appeal letters and enhance operational efficiency by offering suggestions for areas of improvement.
We are offering complimentary 30-minute slots to interested clinicians/coders to learn more about your denials and appeals process, followed by a short review with Advent clinical review experts to offer guidance and opportunities to increase your appeal chances.
If you are interested in a free appeal letter review, fill out this form, and an Advent team member will reach out soon to schedule.
Appeal Management Solutions
5 Strategies to Help Interpret Denial Data
Data and data analysis are an integral part of Appeal Management. In some cases, appeal management teams need help identifying the important information or the trends they should be looking for.
The five strategies in this article can help teams interpret denial data and best utilize it within the denial appeal process.
Optimizing EMRs for Denial Resolution
Providers today are better informed and are prepared to take on more challenges due to the information and flexibility that EMRs provide, yet this technological tool is not without its downfalls. EMRs are notoriously hard to navigate, especially when performing manual reviews.
Learn about the challenges and costly nature of manual EMR reviews and our expert advice on how to solve some of these problems.
Introducing Apello™ - Our Proprietary Claims Analysis Tool
Developed in-house as Advent Health Partners’ proprietary medical claims analysis tool, Apello was designed by clinical and technical nurses, coders, and claims analysts to review claims and build appeals all in one platform.
Apello creates searchable medical record data, with built-in functionality for a multitude of use cases. By enabling your current team to easily increase the total volume of appeal reviews from beginning to end, Apello reduces administrative costs and decreases time to revenue.
The Impact of Apello
Increase communication efficiencies through easily shared documentation with health plans.
Compelling Appeal Packets
Seamlessly create appeal packets pinpointing decision data for compelling arguments.
High Productivity Increases
Increase productivity and output by +300% by streamlining common actions and decisions.
About Advent Health Partners
Advent Health Partners was founded in 2010 as an outsourced healthcare claims review vendor. As our business grew, the Advent claims review team of registered nurses, credentialed coders, and business analysts realized that the majority of their time was spent sifting through medical record documentation, trying to find decision data instead of making decisions. From there, our team began building solutions to increase review efficiencies and pinpoint process improvement opportunities for both health plans and hospitals.
Today, our mission is to share our clinical expertise, industry-leading technology, and best practices with plans, providers, and partners to accelerate appropriate reimbursement and increase review team productivity across the healthcare industry.