Q&A: Tracking denials

Q. When looking at denials timelines, what information should be noted?

A. There are many critical time elements to capture during the denial appeals process. It is recommended that you add these to your denials database. If that is not possible, an alternative spreadsheet or database should be developed. The first date to track is the date that the denial or remittance advice (zero or underpayment) was received. The amount of time allowed to file your appeal will vary from payer to payer. When tracking timelines, it is important to note the:

• Date of the denial letter
• Remittance advice
• Date you actually received it
• Due date (the date the appeal must be received by the payer)
• Date you actually sent your appeal

When establishing the due date, it is highly recommended you input a date that is 10 days earlier than the actual due date to ensure timeliness. These dates should also be built in for each level of appeal. Finally, you should track the payer’s response to your appeal for each level to ensure that they are timely. If not, you have the opportunity to request interest.

For more information, see The Denials Management Training Handbook.

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