How to Win a Medicare Appeal: Electronically Submit Appeals and Discussion Requests
The Refyne Audits solution automates manual, paper-based processes related to Level 1 & 2 Appeals and Discussion Requests from the Centers for Medicare & Medicaid Services (CMS) for more timely submission and reimbursement
Many hospitals and health systems still rely on a complex series of manual, paper-consumptive processes to address recovery audits, appeals and discussion requests for CMS Medicare fee-for-service (FFS) claims documentation. Strict timelines for filing redetermination, reconsideration and discussion requests challenge organizations to file documentation before deadlines pass, as cited in a recent article from the Healthcare Financial Management Association (HFMA).
While it may feel like time is never on your side when it comes to filing appeals and requests, the Refyne™ platform can help streamline and take the stress out of filing deadlines. This fully electronic, cloud-based solution for automated document submission improves the Medicare appeal and request process for hospitals, enabling providers to submit documents in a timely, trackable manner.
Healthcare organizations can submit Level 1 and Level 2 Appeals as well as Discussion Requests using Refyne. They can also participate in the CMS Electronic Submission of Medical Documentation (esMD) initiative to help ensure timely, accurate reimbursement for the care being provided. Benefits of using Refyne include:
Decrease denials by enabling quick, electronic responses to time-sensitive Medicare audits
• Improve tracking of submissions with an electronic audit trail that includes date and time stamps
• Reduce the costs associated with manual printing and mailing of documentation
• Enhance the security of submitted data and help ensure that protected health information (PHI) required for claims submission and coordination of care is electronically transferable and available in a compliant, electronic format
• Access and exchange documentation from existing healthcare information technology (HIT) solutions via Application Programming Interface (API)
• Manage appeals and requests from anywhere, anytime via the cloud
Reduce Level 1 and Level 2 appeal response times
Submit and track appeal documentation electronically to improve response and reimbursement times. Date and time stamps show when appeals were received to prove timely filing.
Simplify the management of appeals and discussion requests with a single, unified platform
Say “goodbye” to printing and shipping boxes of medical records. Thanks to Refyne’s API connection to your HIT systems, you can have instant access to the records you need.
Access Medicare claim appeals from anywhere, anytime
Whether in-office or remote, the cloud-based Refyne platform enables your teams to have 24/7 access to the documentation required to file and review Medicare appeals and requests.