Renee Leary, from Appeal Masters, shares a complete template to let you “hold your place in line”…
For your convenience, the transcript of my portion of this video appears beneath the player. (Does not include interviews.)
Welcome everyone and thanks for coming here and listening in.
I’m Ernie de los Santos, Founder and Faculty Chair of Appeal Academy, and author of “INSIDE RAC SUMMIT” my review of the 30 presentations from last December’s national rac summit.
This is the third video in a series that I’ve created to get some very valuable information out to all of you. It’s entitled, ‘Faster, Better, Cheaper’ – a line I stole from NASA – who needs to minimize the effect of failures or denials, while also maximizing the value of successes or overturned denials, all using limited resources. Sound familiar?
Well, it did to me so I jumped at it — see when I was a kid I always wanted to be an astronaut and followed all the NASA space programs religiously. But I’m over 50 now and that dream is long gone. But I like that new mission statement of theirs, and I also thought it fit this situation perfectly. They need faster, better, cheaper space craft — and you need faster, better, cheaper appeals.
Whether NASA would appreciate my analogy or not, I hope you will and I also hope you find the material useful, and that you might share it with others. I’m sure it can help you not only file and win more appeals, but can also help you personally feel more like you’re making a difference. I know that sometimes you might feel like you’re swimming up-stream or even just treading water — that’s part of why I’m doing all this, to help you both do better and feel better at your job. Although your job is different from any I ever had, I’ve felt the same way, and I’m teaching you the things that made me feel better, throughout my 40-year career. It worked for me, and I’m in a position to share it with you. So let’s get going…
The first video gave you 3 things to do right away, all of which were free to get started with – including great advice from Drew Wachler from Wachler and Associates, an expert healthcare appeals attorney. The second video gave you a tangible tactic to use, right now, based on the idea that a simple appeal is better than no appeal at all, as explained by Dr. Ron Hirsch from Accrective Physician Advisor Services. Now, I’m going to play for you a very important part of this puzzle — if you want to write more appeals and can’t afford to hire more staff, then today you’re going to hear a technique that will work for you, and you’ll even get a very basic template for how to write the speaker calls a “spacer” appeal – a short but effective appeal letter than can buy you some time to write a much better appeal that can win at a later level of appeal.
My conversation was with Renee Leary, from Appeal Masters. Renee has over 35 years of experience in clinical settings, including Case Management, UR and denial and appeals management, on both sides of the aisle – payer and provider. What she’s sharing today is straight from her experience as both a provider and a consultant to providers. Get out your notepad — you’re not going to want to miss what she suggests you do, and you can start using this – today.
So now, let’s listen to my conversation with Renee Leary…
[interview here – hear it in the video, above.]
Ok, now you have the makings of your own template to write these ‘spacer’ appeals. Isn’t that great?! And we’re still not done with this series….
Watch for my next email, for my link to another short interview — but this time, I’ll be talking to Steven Greenspan, from EHR. Steven tells me about exactly what to do to handle those strange appeals that I mentioned at the beginning of the first video – remember? The ones where it looks like you’ve won but the judge gave some strange instructions? Well, Steven is handling several of these cases for EHR clients, and has even gone directly to the well, so to speak — he’s gone to the Chief Administrative Law Judge to get help. I’ll let him tell you about it, but I also hope to hear more from him in the near future, when we see, hopefully, some good news about those strange decisions.
And after that, I’ll be posting an interview with a nationally known lawyer, who has been talking directly with CMS about all this. That should give us all a better idea about what to do with these anomalies in the future.
So stay tuned, for more great content, from Appeal Academy.
I’m Ernie de los Santos, thanks for watching. See you next time!