Starting October 1, 2024, Powerback is expanding its consulting services to include support for denials related to nursing services, beyond just therapy services. This new offering aims to assist healthcare facilities in appealing denials that arise under the Patient-Driven Payment Model (PDPM), especially those related to diagnosis coding and nursing services.
With a registered nurse and certified coders on the clinical denials team, Powerback can help bridge the gap between the payer’s perspective and the documentation that supports the Minimum Data Set (MDS). By thoroughly investigating what the payer sees and aligning it with the documentation, our team helps centers effectively "tell the story" of their patient. This service can extend beyond diagnosis or coding issues, helping to demonstrate the skills needed based on other supporting documentation.
A Track Record of Success
The depth and breadth of expertise within Powerback's team set this new service apart. Our team includes highly experienced professionals—every appeal specialist has been either a therapist or nurse for over a decade, with significant experience in denials management. And, our clinical denials group has a proven track record of success in appealing nursing claims, ensuring that customers receive the support they need.
With a team that specializes in payer policies, Powerback’s denials management service provides an advantage. This expertise ensures that customers are not just reacting to vague and sometimes misleading denial codes but also interpreting them effectively to determine the right course of action.
Why Powerback?
Navigating the appeals process can be daunting. Denial reasons are often unclear, and the regulatory environment is complex. Powerback’s clinical expertise—comprising therapists, therapist assistants, and nurses—provides a unique advantage. Our team spends every day working through denials, allowing them to interpret issues quickly and identify the most effective solutions.
With an over 90% success rate in overturning denials, Powerback's team has developed a proven process for maximizing reimbursement in these challenging cases. While other services might claim expertise, Powerback’s results and deep understanding of both claims and the healthcare regulatory landscape make it the trusted choice for denial management.
Ready to Hit the Ground Running
Although this is a new offering, Powerback’s existing team and the current infrastructure allow us to deliver this service with confidence and efficiency. The foundation for success is already in place, and customers can expect a seamless experience for this expanded support.
How to Get Started
Powerback's consulting services are poised to help centers navigate the complex world of denials and reimbursement successfully.
If you are interested in the Nursing Denials Appeals service, reach out to Powerback's business development team or your current operators. Together, we'll discuss the specific services needed, determine pricing and structure, and create contract language. From there, Powerback’s denials management team will step in to provide the necessary support.
To learn more about this service, connect with our business development team here.
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