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September Sepsis Awareness Month. Join us for three Sepsis Denial/Appeal workshops.

Sepsis is the #1 cause of death in U.S. hospitals, and insurance companies #1 payment denial. Why do we let the payers decide if you have a life-threatening infection? In recognition of Sepsis Awareness Month, PayerWatch and AHDAM join together...

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PayerWatch Wins the 2022 SCHIMA Champion Award

TOWSON, MD, August 16, 2022 — PayerWatch, a leader in solutions to protect healthcare provider revenue from payer denials and audits, is honored to receive the 2022 South Carolina Health Information Management Association (SCHIMA) Champion Award. SCHIMA grants the Champion...

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Advocacy & Policy

Intersect Healthcare submitted comments on April 16, 2021 regarding the proposed rule entitled “Medicare Program; Medicare Coverage of Innovative Technology (MCIT) and Definition of ‘Reasonable and Necessary’’’ (CMS-3372-IFC). If the MCIT Program is implemented and changes to the definition of reasonable and necessary are...

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Meet our new Senior VP of Business Development!

We’re proud to welcome and announce Rick Scott to the Intersect Healthcare team as Senior Vice President of Business Development. Rick Scott recently joined the Intersect Healthcare, Inc. (IHI) and Denial Research Group, Inc. (DRG) as Senior Vice President –...

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A Constipated Appeals System Seeks Relief

Publication: For the Record “The alternative processes may be better choices for providers with disputed claims that fall well within gray areas or that have financial pressures that require a quicker resolution of their appeal and are unable to wait for...

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Intersect Healthcare Achieves HITRUST CSF® Certification

Towson, M.D. – June 20, 2019 – Intersect Healthcare, a provider of denial, audit and appeal management software for hospitals and health systems, has earned HITRUST CSF Certified status for information security. “Achieving this crucial benchmark is validation of our...

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Anthem Blue Cross to pay California $2.8M to correct how it handles complaints

SACRAMENTO — Officials say Anthem Blue Cross will pay $2.8 million to the state as part of a settlement over allegations that the insurer failed to address issues with its grievance and appeals process. https://www.northbaybusinessjournal.com/article/industry-news/anthem-blue-cross-to-pay-california-2-8m-to-correct-how-it-handles-complai/

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Denial Smackdown Volume One

Making a distinction between acute and chronic blood loss anemia is important. It is crucial to recognize and document acute blood loss anemia because the condition is a significant indicator of severity of illness impacting revenue, quality and performance metrics,...

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How well are Statutory Documentation Requirements Decreasing CMS Program Risks?

The Government Accountability Office (GAO) issued a report on March 27, 2019, stating CMS should assess documentation necessary to identify improper payments. The study was performed on Medicare FFS and Medicaid FFS improper payment data for four selected services types—home...

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How well are Statutory Documentation Requirements Decreasing CMS Program Risks?

The Government Accountability Office (GAO) issued a report on March 27, 2019, stating CMS should assess documentation necessary to identify improper payments. The study was performed on Medicare FFS and Medicaid FFS improper payment data for four selected services types—home...

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Hitting the mark: Defend against IRF audits and denials with coding and documentation improvements

Publication: HCPro – NAHRI Journal Correct documentation and coding are key to correct reimbursement, but according to the Officeof Inspector General (OIG), organizations aren’t hitting the mark on either when billing forinpatient rehabilitation facility (IRF) services.

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Seven strategies to build an effective appeal process

Publication: ACDIS Facility appeal writers must craft piles of appeals, with virtually no time to investigate the accuracy of payer denials. However, understanding the appeal process is crucial. Engaging a physician advisor can bring the knowledge and experience of a physician...