- Know your appeal rights, and appeal tactically
- Exercise efficient and effective appeals with the relevant claims administrator (Aetna, UHC, BCBS, etc.) and ERISA plan sponsors
- AVYM can assist NJDPA members on a discounted basis with the following:
- Learning basic claims appeal procedures
- Interpreting EOBs/ERA 835s and recognizing denial types
- Challenging and potentially overturning overpayment refund demands and offsets
- Challenging and potentially overturning fake “PPO” or “Negotiated Discount” denials
- Preparing for and responding to audits and SIU reviews.
Watch the video: Understanding the EOP & ERA 835 and recognizing fake PPO discounts. Must be a member to watch the video.
Watch the video: "Overpayment Recovery (WO)" takebacks and cross-plan offsets. Must be a member to watch the video.