Second Review Strategy Kit, Part I

June 09, 2016 51 min
Hosted By: Sarah Moray
Payment Appeals
Want to improve your Second Review (SBR) results but don’t know how? Our experts share their extraordinary strategies, insider tips, and the sample language to get Second Reviews processed correctly.
This webinar dives deep, going into the specifics that make all the difference between payment and another denial.
  • Downcoding: how to combat, how to detect, and our astonishing statistics--it happens much more often than you think.
  • How to correctly read and analyze explanations of review (EOR).
  • Independent Bill Review (IBR) decisions that you can use to dispute specific types of incorrect payment.
  • Second Review questions, answered!
  • Specific reason for Second Reviews, including sample wording for:
  • E/M visits incorrectly downcoded
  • Authorized services denied as not authorized
  • PPO / Network reduction incorrectly applied
  • CCI Edits incorrectly applied
  • PTP visits incorrectly denied
  • Claims administrators also benefit from our examination of compliant SBR tactics and our discussion of the most common mistakes.
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Worker’s Compensation billing is disturbingly convoluted. We take pride in reviewing the laws, rules, and policies and, to the best of our ability, explaining what we’ve read in plain English.

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If you seek legal advice or representation, please contact a licensed attorney in your jurisdiction who specializes in Workers’ Compensation.