In an already complicated reimbursement landscape, claims denials can potentially pose a serious issue to the financial revenue for rheumatology practices. Denials are not only highly prevalent in the healthcare environment, but also costly to appeal, which affects overall reimbursements. According to The Physician Billing Process: 12 Potholes to Avoid in the Road to Getting…
Tips to Manage, Prevent Medical Billing Claim Denials
Physicians are increasingly fighting multiple forces in running a practice, and one of the most common barriers to effective revenue cycle management is frequent medical billing and claim denials. An insurance company’s denial for services places a significant strain on the financial process of the practice, which affects the bottom line. According to the Medical…
Undercoding Is Not an Audit-Proof Strategy in Medical Documentation
Overcoding is a common term used when discussing fraud and abuse in reporting procedures and services not supported by the actual work performed. Alternatively, undercoding—or failing to report the full extent of services or procedures provided—is an equally unsound practice and a compliance risk. In the world of quality reporting, undercoding can have damaging effects…
How to Manage Denials of Evaluation and Management Coding for New Rheumatology Patients
Tips on defining new and established patients; determining an appeal approach
Practice Page: Denials Management Can Help Maximize Reimbursements for Physician Practices
How to set up a strategic plan to appeal denied medical claims
Maximize Reimbursement by Managing Denials
Could you use an additional $50,000 to $80,000 in revenue each year? If you are like most clinicians, you have superbills and well-trained office staff but you still receive frequent denials. Though some denials are appropriate, many can be corrected and the lost revenue recovered.