denials prevention

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    Wiki How to Avoid Billing Overlap with PCPs in Specialist Setting

    I am currently assisting a specialist practice in implementing Chronic Care Management (CCM). These are CPT codes 99490, and 99439 While they understand that as specialists, they can bill for these services, they have concerns regarding potential overlaps in care with local primary care...
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    Wiki J2790 denials

    We have repeatedly billed J2790 with NDC N400562780501 300 MCG or N400562780505 UN 300mg with e/m 99214 both with and without modifier 25 and nothing works to get reimbursement on the J2790. We get denials for either billing errors or incorrect NCD. I have repeatedly called Provider Relations...
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    Wiki Weight management billing

    I do billing for a provider who considers himself a weight management specialist. His primary method is a combination of medication and weight management counseling. He also acts as a PCP for his regular patients, but his main priority is weight management. When we bill insurance, we typically...
    • mforsyth
    • Thread
    • appeals billing coding denials prevention insurance billing weight weight loss
    • Replies: 0
    • Forum: Billing/Reimbursement
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    Wiki ER to Inpatient on Same Day: Different docs, same TID

    Hey all, The hospital I work for have our ER physicians and Hospitalists under the same TaxID. When our ER physician sees a patient and admits to inpatient: then the hospitalists sees the patient the same day- We are getting the ER charge denied... Is this correct? Is there anyway around this...
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    Wiki cpc with outpatient, hospital and facility experience

    Nichole Morris, CPC NicholeHMorris85@gmail.com Medical Billing & Coding Accomplished professional with solid background in health care clinical operations, including medical billing and coding standards, financial policies, and medical record documentation. Expertise in insurance...
    • harrin
    • Thread
    • chemotherapy coding claim denials coder 1 denials prevention facility billing hospital coding infusion coding oncology revenue cycle management
    • Replies: 0
    • Forum: Resume Postings
  6. M

    Wiki Denials prevention

    Hello, everyone I have been given an opportunity to become a denials prevention specialist. I just need clarification on what this role actually does and what they are to see on a day to day basis. Also what is to be expected? Please and thank you, I just want to be prepared before start date...
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