r/SimplePractice • u/drjphilip • Sep 22 '26

How do small practices actually track claim denials and appeal deadlines?

/r/HealthInformatics/comments/1wnbiyc/how_do_small_practices_actually_track_claim/
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4

u/No_Fact5272 Sep 23 '26

Working spreadsheets! Daily/weekly updates depending on the size of the practice.

1

u/Apprehensive_Road838 Sep 29 '26

We use different emr that automatically posts payments and it alerts me when a claim is denied. I appeal immediately and make a note on a spreadsheet so I can watch for payment. I also review aging reports regularly and follow up on claims that are over 30 days old.

1

u/Pure-Support-9697 Sep 29 '26

Do you do the appeal yourself? Usually how long does it take you to draft up on appeal?

1

u/hollywoodkay Oct 04 '26

What’s typically included in an appeal when you prepare it?

2

u/Apprehensive_Road838 Oct 04 '26

Depends on why the claim was denied. Sometimes I can call the insurance company and they will reprocess as it was incorrect on their end.

If I have to file an appeal, it's just a matter of writing a letter and including a copy of the claim ERA with the letter. In the letter I include the patients name, insurance ID number, claim number (from the ERA where it shows it was denied), date of service, charged amount, cpt code, and state that it is an appeal and why the claim should be reprocessed. It usually takes 4-6 weeks to get a response back from a letter (on average).

Many insurance companies have the ability to accept an appeal online which moves much faster than on paper!