The Payer Said No: When Should You Actually Fight the Denial?

A payer says no—but does that mean you should appeal? In this episode of Practice Perfect, Jennifer McNamara and Maya Turner break down when to fight the payer, fix the claim, or fix the process. From medical necessity and prior authorization to credentialing, patient responsibility, modifier 59, and payer policies, they discuss why understanding the reason behind a denial matters before taking action. They also touch on Independent Dispute Resolution and how to know when an appeal is worth the time.