Organizations must ensure their procedures are aimed at preventing and managing denials. One way to accomplish this is by looking for opportunities to involve other departments. Use these tips to improve interdepartmental denials management.
Healthcare providers know that denials are not a matter of if, but when. One way to prevent and manage denials is by looking for opportunities to involve other departments.
CMS developed the National Correct Coding Initiative (NCCI) to control improper coding and potentially inappropriate payment of Part B services. Review NCCI basics to ensure compliance with the latest coding policies.
Clinical validity denials occur when there is a lack of clinical evidence in the patient chart to support a billed diagnosis. Learn more about common reasons for these denials and how to defend against them.
Coding and billing professionals must ensure that medical record information is accurate, up to date, and compliant. In this article, Holly Cassano, CPC, CRC, defines late entries, corrections, and addendums, and explains the proper methods used to alter health records while maintaining Medicare compliance.
Coding and billing professionals must ensure that medical record information is accurate, up to date, and compliant. In this article, Holly Cassano, CPC, CRC, defines late entries, corrections, and addendums, and explains the proper methods used to alter health records while maintaining Medicare compliance.
Various analyses must be conducted to maintain compliance, assist with charge capture, solve account edits, and review any possible coding trends or issues that may cause claim delays, denials, or unnecessary rework. Learn how to effectively leverage this data to improve processes and protect revenue.
A report released last month by the American Hospital Association (AHA), called Commercial Health Plans’ Policies Compromise Patient Safety and Raise Costs, found that not only is the cost of private health insurance raising affordability issues for American consumers, but policies, such as prior authorization requirements, may increasingly be putting patients at risk and driving up hospital administrative costs.
