In Audit
Sep 2nd, 2019
Lower denial rates are key to turning around large healthcare organization payment issues. When you are a large organization, the number of denied claims can be overwhelming and cost a staggering amount of money. To manage this can be a scary prospect — but fear not, we are here to help. Two things are crucial ...
In Billing
May 29th, 2019
There are the standard reasons medical claims are denied, such as putting the wrong modifier on a code or putting the diagnoses in the wrong sequence. But did you know that some reasons are not the fault of medical coding? 5 Ways Your Claim Can Be Denied Denials can be cause by more than an ...
Be on the lookout for clues to submit a successful appeal. Denials and appeals can be the most frustrating parts of a coder’s job. I have been on both sides of the fence — working pro-fee for a healthcare system, handling denials, and working for a payer, looking at denials. In my experience, there are ...
In Billing
Feb 5th, 2019
Coding clean-up crew lays the groundwork to improve healthcare reimbursement through denial management. In large healthcare business offices, medical billers and coders are often in separate departments, with separate leadership. Although the medical billers are largely responsible for denial management, they often don’t have the necessary coding expertise required to properly work coding denials. ...
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. ...