Purpose of the General Appeal Process

Checkpoint : Purpose of the general appeal process

Alisha Johnson

June 29, 2012

HCR/230

The main purpose of the general appeals process is to give the physicians a chance to. Appeal a decision of a claim that was reduced or down coded. But the physicians have to deal with some steps of the process, before he or she receives a final decision. There are a lot reasons why a person will want to put in an appeal. The very first reason why a person would put in a claim for an appeal might be. Because the physician’s office use a old code that was out of date. And if that did happen it could cause the physician to be reimbursed at a lower costs. If the losses are added up the right way the physician could request, an appeal to change the amount of losses to the correct amount. The next way an appeal can be helpful to a physician is if the physician has to put in a claim. Because of possibly classifying the losses incorrectly ( Classifying a medical only loss as a lost time claim) A physician that have what is known as a quality control person overseeing the claims that are going out. Have the chances of receiving an audit notice as likely it’s always better to double check a claim for possible errors. And the reason why a medical biller should check for errors because it’s always easy to make an error. When he or she is filing a claim and the reason why it’s a lot of information a claim need.