'Heal that Claim' Month: Take Time to Review and Appeal Inappropriately Paid Claims

September 16, 2008

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November is "Heal that Claim"™ month, and all physician practices are encouraged to hold health insurance companies accountable for making claims processing more cost effective and transparent as part of the American Medical Association's (AMA) "Heal the Claims Process"™ campaign, which the AMA launched earlier this year.

Because physician practices often experience an increase in underpayments and denials during the last quarter of the year, November is an ideal time to appeal inappropriately underpaid or denied claims. Instead of accepting increased claims underpayments and denials, physician practices can appeal these claims and collect their appropriate payment in January and February. Payments from payers are reduced for those two months, as many patients meet their out-of-pocket deductibles.

So in November, start reviewing and appealing any inappropriately paid claims. Once this becomes a routine, your practice can increase its efficiency and revenue.

Read more information on the campaign and for valuable resources and tools to help your practice review and appeal claims.