In Audit
Jan 8th, 2019
Explanation of Medicare Benefits (EOB) error message 96 Non-covered charge was the No. 1 reason for claims denials in December in all of Medicare Jurisdiction H, according to the region’s Medicare Administrative Contractor (MAC). “Prior to performing or billing a service, ensure that the service is covered under Medicare,” Novitas Solutions says on their website. ...
Claim denials cost the medical industry over $1 million, annually. How much of that comes from your practice? You spend time interpreting sometimes confusing health plan benefits and coverages and wordy coding guidelines. You go through time-consuming prior authorization processes. And you sign up for a payer’s electronic funds transfer and post claims per their ...
In Billing
Dec 5th, 2017
There’s usually a reason and a solution for every denied claim. Claim denials are inevitable. The first step to work through them is understanding the most common denials, such as: bundling; global denials; multiple frequency denials; and no plan coverage denials. Bundling Unbundling occurs when a service is billed using individual codes when a single, ...
Dedication, education, and denial prevention are key to reversing the aging process. The goals of working your aging report are simple: Get claims paid, learn how to prevent denials, educate, and reduce the aging status. Here’s how to meet those goals. Make Aging Reports a Priority Depending on the size of the office or facility, ...
In Audit
Oct 16th, 2017
You billed the insurance company for a service provided by your office only to receive a denial remittance. Is the denial valid? Why wasn’t the claim paid? Who can review the explanation of benefits summary and make a determination? Enter the appeals analyst — an essential position for physician offices, hospitals and clinics, as well ...