Tag: denials

Tips to Optimize Cardiology Billing and Coding Process

Top Tips to Optimize Your Cardiology Billing and Coding Process

Cardiology Medical Billing and Coding Process: To effectively handle these changes, cardiology practitioners might have to keep themselves informed about the modifications in payment regulations, modify their billing procedures as needed, and employ novel methods to enhance their compensation. Cardiology billing and coding can be challenging due to various factors, such as the complexity of […]
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The-State-of-Claims-and-Denials-in-2023

The State of Claims and Denials in 2023

How do you resolve a repeated and shooting up problem like claims denials? It’s been a fresher subject for revenue cycle management professionals for years that are only experiencing hotter with the growing pressures of staffing shortages, troubles with staff movement and instructing and developing policies and protocols at the government and payer levels. On […]
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Administrative-Policies-Overburdening-Providers

Administrative Policies Are Overburdening Providers

Some commercial health insurers are using policies that can delay patient care and create burden for providers, causing relationships with hospitals to worsen, according to a survey by AHA. The association fielded responses from more than 200 hospitals in 2019 and from 772 hospitals between December 2021 and February 2022, creating data that both predates […]
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New Patient E/M Denials: Mystery Solved

New patient evaluation and management (E/M) claims are being denied when the patient was previously seen by a specialty physician assistant or specialty nurse practitioner on staff. This is happening when another provider of a different specialty in the same multi-specialty group sees the patient for the first time and bills a new patient E/M […]
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5 Tips for Making Prior Authorizations Less Burdensome

A 2016 study in the Annals of Internal Medicine found that for every hour physicians spend in direct face-to-face clinical time with patients, they spend nearly two additional hours on desk work. According to the American Academy of Family Physicians (AAFP), this administrative burden is one of the primary complaints of its members, and prior authorizations top the list of […]
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Evaluation and Management Codes…Why Bother?

Denials and how to not get discouraged with evaluation and management codes, and how to appeal There Is Little More Frustrating To Chiropractors And Billers Than Evaluation And Management Codes: While the service is required both clinically and documentation-wise, it is being bundled more and more often by third-party payers. If both the chiropractic manipulative […]
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  • January 23, 2019

Four Ways RCM Must Transform for the Shift to Value-Based RCM

Value-based care is driving transformation of many established operations within medical groups—and the revenue cycle is no different. It is likely that 2018 will be remembered as the year that value-based care became a financial reality for most U.S. medical practices. Those participating in MIPS (the Merit-based Incentive Payment System) received their first round of […]
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  • January 15, 2019

Non-Coverage Denials: Cause and Cure

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. This should be […]
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