InterviewsNOW on HealthcareNOW Radio, weekdays at 1:30pm ET.
Guests: Brian McGraw, Co-founder, President & CEO, Intersect Healthcare
Twitter: @IntersectAppeal
On this episode of InterviewsNOW, host Shereese Maynard talks to Brian McGraw, Co-founder, President & CEO, Intersect Healthcare about payor denials and appeals.
Brian answers the following questions in their 30 minutes together:
- I read a recent statistic that said Medicare Advantage plans overturn 75% of the denials hospitals appeal. So if the upside of appealing a denial is so huge, why don’t more hospitals appeal payer denials?
- Can you describe the member’s right of appeal and how hospitals should be using this right to their advantage?
- I’ve also heard rumors that commercial payers are increasing their denials. Is this true?
- Can you elaborate on this issue? What are your customers telling you with regard to the types of reviewers employed by payers?
- Earlier in our interview you mentioned centralized denial management as a new strategy to combat denials and win appeals. Can you describe how your software supports a centralized denial management and appeals team?
- Finally, you mentioned that payers are winning the denials and appeals game by using their data more effectively than providers. What types of data analysis or reports does your system provide and can you give us a common example or case scenario?
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About Intersect Healthcare
Intersect Healthcare, Inc. (IHI) is one of the nation’s leading providers of Payer Compliance and Audit & Denial Management software for healthcare providers. Intersect Healthcare has developed the most comprehensive solution for managing audits, risks, denials, and appeals. Currently used by over 300 healthcare systems nationwide, the VERACITY™ software suite is an easy-to use, effective, and affordable solution that integrates both paper and electronic record systems. Intersect Healthcare, Inc. leverages Software as a Service (SaaS) technology to assist organizations in streamlining processes, reducing costs and complying with regulatory requirements.
About the Show
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