Fighting the Rising Tide of Claim Denials: A Physician Speaks Out

Denials by payors for hospital claims continue to mount. Hospitals should take every opportunity to have a denial overturned – and an oft-neglected method is with a peer-to-peer call for a concurrent denial. A physician advisor can dedicate time and resources to accomplish it, but what do you do when the payor insists on only speaking with the attending physician?

Since this is a recurring issue with providers and auditors, Monitor Mondays has asked Dr. Chris Shearer to report on this untenable issue – and to offer advice to other providers.

Other segments will include these instantly recognizable broadcast segments:

• The RAC Report: Healthcare attorney Knicole Emanuel, partner at the law firm of Practus, will report the latest news about auditors.
  
  
• SDoH Report: Tiffany Ferguson, a subject matter expert on the social determinants of health (SDoH), will report on the news that’s happening at the intersection of healthcare regulations and the SDoH.
  
  
• Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment.
  
  
• Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will be making his Monday Rounds with another installment of his popular segment.
  
  
• Legislative Update: Matthew Albright, chief legislative affairs officer for Zelis, will report on current healthcare legislation.

Chapters

• 0:58 Ronald Hirsh, MD
• 4:41 Knicole Emanuel, Esq.
• 8:46 ACPA Commercial
• 9:49 David Glaser, Esq.
• 14:50 Tiffany Ferguson
• 18:49 Matthew Albright
• 23:16 Listener Survey with Tiffany Ferguson
• 24:11 RACmonitor Commercial
• 25:03 Chris Shearer, MD
• 29:38 Q&A