Wiki Coding vs. Working denials

[mstallings]

I would like to hear about working denials. What is your process? Currently, I code services, bill services and then also work the denials. However, we have what we call "medicare rep's" and "standard insurance rep's".....when a charge gets denied, the denial goes to their work list and then they (ins/care rep's) transfer this to us, basically telling us why insurnace denied. We work the denial and send back to them for review or correction. How does others do this? :confused

 

[Walker22]

There is no right or wrong way, as long as someone is working the denials. In my office, we have billing staff, A/R staff. and coding staff. The billing staff gets the claim out. If it gets denied, the A/R staff work the claim. If they discover that there was an error on the claim that caused the denial, this information is communicated to the coding staff, who verify it, and then communicate back to the billing staff so future claims do not have the same error.