Part D Success Story: $24k Denied, Then Reversed
By Sheila Chandler, Accounts Receivable Solutions
If you feel like you’re getting the runaround when it comes to getting paid for Medicare Part D, you’re not alone. Recently, Accounts Receivable Solutions helped a home infusion provider reverse a denial for more than $24K in revenue for services that had been previously authorized by the insurance company.
Appealing a denied claim is daunting, but can be worth the time and effort. The bottom line in recovering payment is PERSISTENCE and GOOD DOCUMENTATION. Wouldn’t it be great if there were specific steps we can follow to get payment for services provided? As those of you who are responsible for collecting for Part D services, this is not the case. Rather than summarizing our process in this case, I thought it would be most helpful to include the appeal letter we used in full. If you'd like to read the letter, click here.
I’d be happy to share any additional information I have on succeeding with Medicare Part D and would like to network with any one else to learn what is working for you. Until such time that there is a clear guideline on how to get paid for Medicare Part D home infusion services, we all need to work together for our companies and customers.Please feel free to contact me at:
Sheila Chandler
schandler@accounts-receivable.com