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An Appealing Option: The Benefits of Automated Appeal Letters

Creating appeal letters is a common item on the “to do” list for billing staff at physician practices. Unfortunately, it’s one that often takes much more staff time than it really should. That’s because you have to hunt down why the appeal letter needs to be written; find and complete a specific form for that payer to appeal the decision; and confirm the separate address to which the appeal letter must be sent. This can obviously become a time-consuming process.

In today’s healthcare environment practices need to find a way to streamline this process so they can save valuable time. Saving even ten minutes for each appeal letter over the course of a year, for example, can be significant. It gives you the time and energy to focus on other important tasks.

One item the industry as a whole should start to consider is automated and standardized appeal letters to help make the entire process more efficient. When this is achieved practices:

  • Improve efficiencies because staff no longer has to manually go to each payer’s website, download the letter and complete the letter by hand. Automated appeal letters can often be created in about 5 minutes, instead of the 15-20 minutes it takes to manually create a letter. When payer information is automatically populated, appeals can be sent to the right place the first time they are sent.
  • Increase rates of successful submission. A strong, organized, easy-to-read and well-written letter has a greater impact on insurance companies because it can be crafted and targeted for a specific payer and/or reason for the denial. Some practices have seen 95% success rates with large payers after implementing an automated process.
  • Ensure accuracy and prevent errors because remittance information is automatically pre-populated into the letter, along with the date and time the letter is created. This also helps reduce the chances of a second denial.

Implementing automated appeal letters is an easy way for your practice to save money and streamline processes for a more efficient workflow. The letters are easy to use and often don’t require a lot of training time for staff—so they can get right to work. Ideally, your clearinghouse should include automated appeal letters with their denial management tool-set. Even though you should experience reduced rejection and denial with your clearinghouse, there is still a need for denial management to make sure that no money is left on the table.