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  • This might be stating the obvious but our grievance committee has been successful lately after re-thinking the claim writing process and going back to basics. I looked at all the ways we were being denied on merit and worked backwards to how we could have won it. We have had a lot of success with just sticking to the 5 W’s and keeping the argument limited to undisputed facts based on the contract language, without trying to outsmart the reviewing officer with suppositions or proving that they lied during a conference. It seems if you do not give them a life preserver to grasp then it is difficult to spin.

    Michael S.

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