InDefend: Your Time, Your Money
Traditionally it's been much too difficult to be prepared on the merits quickly. Relatedly, it's also very unlikely that the bedside or hospital physician is available to explain the case that quickly. We solve both problems. When the hospital can complete the appeal that quickly it eliminates a big administrative burden, reduces the complexity to a level that can be handled by a case manager, and gives the hospital much greater financial/budget certainty.
The appellate process has five stages, with a total possible duration of 2.5 years. Most cases take approximately 1-1.5 years to complete. CMS regulations permit a substantive physician:physician peer discussion within 30 days. Typically the hospital foregoes this opportunity. With InDefend you don't have to. You can get your answer right away.
Typically the appeal remains an active item on the institutional docket for more than a year, with substantial administrative time dedicated to managing this process. As the response from the hospital varies at each level, the case manager often must communicate sporadically with a physician or colleagues if the hospital expects to win the appeal. We eliminate all of the logistical complexity (including long meetings with many people regarding same!) associated with winning an appeal. Our software gives you a comprehensive response immediately.
In addition to the extreme efficiency of an InDefend response,our quality is industry-disruptive. Only InDefend offers extreme quality with every single appeal. There are no "weak" appeal responses. Every individualized response is written by a physician team and is as complete and as strong as the relevant scientific literature allows. In short, we give you the best chance, by far, of retaining each inpatient appeal representing thousands of dollars.
Because the process is so long, and the clinical content is so specialized, it is nearly impossible for a hospital to manage these appeals consistently. Usually different people must step into the case at different times. This duplicates effort and guarantees inconsistent quality. In addition, there is a tremendous nationwide shortage of case managers - which also contributes to hospitals' poor response rate/quality to appeals. InDefend delivers consistently excellent quality and any nurse can be trained in our software.
Win or lose, hospitals have to manage budgets with very slim margins. That process is made easier when financial uncertainty is eliminated. An appeals process that takes years is difficult for the CFO. Because InDefend can be deployed within the 30-day peer discussion period, the hospital will either have a definite answer very quickly or have a clear indication as to the odds of wining/losing.
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