Simply accepting the terms laid out in insurance demand letters, subpoenas and audit notifications could prove to be a massive mistake for your practice. In many instances, you can reverse payer investigations, audits, accusations, and recoupment requests—but it all depends on how you respond.
Once you receive a demand letter, your first course of action should be to craft a response that can help move the needle in your favor. However, this is not as easy as it sounds. To be successful, your responses must be tailored to specific nuances in each letter. This might not come naturally at first, but it can become second nature, if you know how…
National appeals management expert Sean M. Weiss, CHC, CMCO, CEMA, CPMA, CPC-P, CMPE, CPC, can help. During his online training session, Sean will provide you with actionable tips that you can use to respond to every possible type of demand letter you’ll receive. He’ll walk you through the specifics of how to respond to audit requests, recoupment notices, inspection alerts, subpoenas, and other notifications you may get.
Here are just a few of the time-tested insurance demand letter response strategies you’ll receive by attending this 60-minute online training:
- Write engaging responses without giving away too much information
- Utilize proven response verbiage that will get attorneys, payers and others on your side
- Overturn recoupment demands and get your money back
- Stave off audit requests with time-tested language that works
- Justify medical necessity when payers believe you haven’t proven it
- Successfully appeal documentation requests within the deadline by mastering response timelines
- Differentiate a notice of investigation from a demand for records
- Combat overreaching subpoena requests by successfully putting legal guidelines to work for you
- Identify when it’s time to call a lawyer and when you can go it alone
- Reverse payer decisions, even when they claim the determination is final
- And much, much more…
Your response to a demand letter could be the difference between hanging onto thousands of dollars and having to pay it back, so this training could be one of the most cost-effective things you’ve ever done for your practice. Not only will Sean help you craft your response plan, but he’ll also lay out the step-by-step process every practice must utilize to successfully respond to every type of demand letter you might receive.
Don’t hesitate. Sign up for this 60-minute online training today so you can respond to every letter without stress. Register right away to ensure your access.
Sean has dedicated his career to serving and advocating on behalf of health care providers, hospital networks, and integrated health systems to ensure a level playing field and due process. Over the past 27-years Sean has focused on helping organizations achieve measurable financial results to ensure stability in their market all while significantly reducing the risk of non-compliance. Sean’s knowledge of the inner workings of government agencies at both the state and federal level make him an invaluable asset to clients.
Sean leads the strategic litigation defense and audit team for DoctorsManagement, LLC. Sean is engaged by the largest and most revered law firms in the nation on matters tied to the False Claims Act and Health Care Fraud Statute cases to ensure the best possible defense for clients targeted by government agencies, their contractors, and commercial payer special investigative units. Sean serves as a third-party Compliance Officer for numerous nationally-recognized organizations across the country creating and ensuring a “Culture of Compliance” to mitigate risk and culpability.
