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The Billers’ Association for Long-Term Care is a membership community created specifically for long-term care billing professionals. This national association provides members with a resource of continuously updated tools, billing-specific education, and reimbursement and regulatory guidance. Become a member today and join your long-term care billing colleagues as you navigate the evolving world of post-acute care billing.

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Tips to win an appeal

January 19, 2018
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Billing Alert for Long-Term Care

Without every “i” dotted and every “t” crossed on a claim, an overpayment may result, even if the services rendered were necessary for the patient. The appeals process is designed to give providers a chance to explain their case; it’s also a mechanism to make sure an audit has been properly conducted. Mistakes happen, even among auditors, who have the leverage to demand large amounts of money in refunds. As a result, there must be some checks and balances in the system, and if done correctly, the appeals process is that balance. The following tips may not help you win every appeal, but they certainly won’t hurt.

 

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