AskMariaTodd™

DENIED CLAIMS APPEALS

image of Medical Claim Denied Stamp
Frustrated by managed care plan tactics to delay payments and test your resolve?
Short on time or trained staffers to appeal claims and recover cash?

Hospitals are writing off more denied claims dollars that ever before. For the average small rural hospital this can mean the difference between sustainability and closure.

AskMariaTodd™ to evaluate the situation and see if she believes she can overturn the denial. If she believes she can help, assign her to appeal high-value claims for you on a contingency basis. 

Getting paid what you’re owed inspires your team to exceed their stretch goals

Invite Maria Todd to your facility to conduct a denied claims appeal training workshop today!

Your staff wants to do a good job. But there’s no commercial academy or course to send them to learn what they truly need to know to fight denied claims effectively. That’s probably because it all starts with what was negotiated in a contract. 

Bring a custom academy to your facility or clinic today and let’s get the team trained and proud of their results.

DENIED CLAIMS APPEALS CONSULTING

ROOT CAUSE ANALYSIS

Maria examines the denial codes, their occurrence frequency, and attempts to discover if the problem is external or internal. Her forensic analysis identifies the reason(s) for the denied claims you’ve experienced and she interprets the data to design and deploy a remediation strategy.

Many denied claims caused by external problems can include an improper system load by the payor, or ambiguous language in your contracts. Once the root cause is determined, a number of approaches can be deployed to rectify the matter. 

TYPICAL PROJECT INCLUDES:

Initial CLIENT Discussion • DENIED CLAIMS REVIEW • ContractS Review • FORENSIC ANALYSIS • 60-minute online, screen-shareD team debriefing w/ RECOMMENDATIONS AND NEXT STEPS TO REMEDY THE PROBLEMS FOUND

AVERAGE ASSIGNMENT BUDGET:

~ $7500 USD

photo of Maria Todd reviewing managed care contracts with a client

ON-SITE TRAINING CLASSES

Train your executives, managers, analysts, and negotiators to manage denied claim appeals better, fill knowledge gaps, learn the latest trends,  lower the frequency of denials due to internal and external causes and reclaim your independence from outsourced agencies and their commissions.  Up to 35 participants.

TYPICAL PROJECT INCLUDES:

Initial CLIENT Discussion • course preparation • travel time & expenses* • course materials for duplication • 6 hours interactive and lecture class time per day • use one of your existing contracts and denied claims as teaching examples • one hour post workshop interactive web conference for follow up questions.

AVERAGE BUDGET PER CONTRACT:

~ $4500 USD

COACHING & CONSULTING

COMPLIMENTARY INITIAL 15 MINUTE INTRO CALL

Schedule a consultation or coaching session with Maria Todd to allow your team to ask questions, fine tune strategies, troubleshoot denied claim appeals, review denied claim appeal strategies, discuss proposed amendments, address stalemates and medical necessity denials and plan negotiation strategies and tactics.  By phone or in-person (travel not included).

HOURLY COACHING & CONSULTATION FEE

$300 USD  (BILLED IN 15-MINUTE INCREMENTS)

OUTSOURCED APPEALS

Maria Todd occasionally accepts assigned appeals on high-dollar, complicated denials. She leverages her training and experience as a health law paralegal and revenue management expert. She only accepts claims after review and a determination that there is grounds and high probability that she can overturn the denial.  Her specialties include claims from ERISA employers, workers comp controverted claims, motor vehicle and other third party liability claims, probate, and other technically complicated matters. Claims for amounts lower than $2500 in contractually allowed fees are not accepted on a percentage of recovery basis.

% OF RECOVERY:

MINIMUM CONTRACTUALLY ALLOWED VALUE: $2,500 / CLAIM