Overview
After an appeal has been filed and processed by a payer, the payer may decide to uphold their original denial determination. If research determines that you should file an additional appeal on a claim, OneSpot can assist you with this action. Filing another appeal will change the previous one's status to 'Upheld' while simultaneously creating a new appeal.
Uphold Appeal - File Another Appeal
1. To begin, access the previously appealed claim in OneSpot (Aging>Claims>By Claim Status>Under Appeal). Then, select the applicable claim to open its 'Claims Details' and view the 'Appeals' tab.
2. Select the three dots to the left of the appeal.
3. Select 'Uphold Appeal.'
4. 'Upheld Date' will default to the current date, if needed this can be edited.
5. Enter a comment. This could include the payer's reason for upholding the original denial.
6. Select 'File Another Appeal' then, complete the following fields:
- Filing Date: This will default to the current date. If needed, this can be edited.
- Check on Appeal: This will default to 30 days from the current date. If needed, this can be edited.
- Upload Appeal Documents: If you have documents ready to be uploaded, you can select the 'Upload Appeal Documents' box. If not, you can unselect this box, and documents can be uploaded later.
- Comment: Enter a comment. This could include a more detailed reason for filing another appeal.
7. When finished, select ‘File Another Appeal.’ If you do not want to save the information, select ‘Cancel.’
Note: If you selected the 'Upload Appeal Documents' box, continue to the next step. If finished, select 'Close.'
File Another Appeal + Upload Documents
1. Select 'Choose File,' then select a document from the dialogue window.
2. Select a 'Document Type' from the drop-down menu. If 'Other' is selected, the 'Document Summary' field will display and allow you to enter a more detailed description.
3. Select 'Upload Document' to finish uploading the document. Select 'Cancel' if you do not want to proceed with the upload.
4. When finished, select ‘Close. ’A success message will display to confirm that the document was uploaded. The document can now be downloaded selecting its name. The original appeals status will be updated to 'Upheld,' and a new appeal will be generated.