Q: How should we handle denied claims when the payer refuses payment under the billed status? Do we need to document that the status was changed only because the payer did not agree to any other options?
In addition to physical and technical safeguards, the HIPAA Security Rule requires covered entities and business associates to implement administrative protections, including workforce training and management.
The U.S. healthcare system wastes some $760 billion to $935 billion dollars each year, says a recent study published in the Journal of the American Medical Association, and between $27.2 billion and $78.2 billion of that total is the result of failures in care coordination.
The fiscal year (FY) 2020 ICD-10-CM Official Guidelines for Coding and Reporting, released shortly after the FY 2020 ICD-10-CM code release, provide instructions for healthcare professionals on how to appropriately report complex diagnoses. Coders should take time to review these changes that were implemented October 1.
In today’s virtual environment, with its focus on flexible schedules, organizing the coding function requires consideration of time zones, team member skills, volume of work, and claim-processing schedules.
