Accurate clinical documentation is the bedrock of the legal medical record, billing, and coding. It is also the most complex and vulnerable part of revenue cycle because independent providers must document according to intricate and sometimes vague rules.
As OPPS packaging has increased, providers may be less likely to appeal claims for certain denied charges based on medically unlikely edits, since it would not increase payments. However, providers should consider appeals when services are medically necessary and appropriate, as CMS bases future payment rates on accepted claims.
Ever since Pat became a nurse case manager three years ago, both family and friends have reached out to her for healthcare advice. She really doesn’t mind and almost expects it, especially since healthcare can be complex and challenging. By sharing her knowledge as a case manager, Pat can often help people navigate healthcare complexities.
Ever since Pat became a nurse case manager three years ago, both family and friends have reached out to her for healthcare advice. She really doesn’t mind and almost expects it, especially since healthcare can be complex and challenging. By sharing her knowledge as a case manager, Pat can often help people navigate healthcare complexities.