Tag Archives: denial management

Top 7 Challenges with Wound Care Medical Coding

Medical necessity denials traditionally focus on high-dollar MS-DRGs, such as those for hip and knee replacements; other MS-DRGs may also soon become targets. We have identified some of the challenges in Wound Care Medical Coding. Healthcare providers are likely to perform … Continue reading

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Top 5 Outpatient reimbursement questions for Wound Care

Do outpatient reimbursement challenges frustrate you a lot? Medicare reimbursement regulations that are currently impacting wound care practices. Wound care professionals still have to follow the coding, payment, and coverage regulations for submitting claims to traditional Medicare. Below are top … Continue reading

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How Medical Billers and Coders (MBC) changing the face of General Surgery Medical Billing?

General Surgery, in the midst of forte explicit medical procedures, has not lost its sheen, and general specialists keep on being the particular decision for various surgeries. Doing negligible obtrusive medical procedures (applying creative and progressed Robotic innovation) for more … Continue reading

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EVALUATING YOUR AMBULANCE TRANSPORTATION MEDICAL BILLING PROCEDURE

  Ambulance medical billing has been under the lens of Medicare for a very long time due to the fabrication of medical charges and unreasonable billing rates for the patients during an emergency. In September 2015, a report was released … Continue reading

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Acquaint Yourself with 9 New HCPCS Modifiers

A modifier is a two-digit numeric or alphanumeric character reported with a HCPCS code, when appropriate. Modifiers are designed to give Medicare and commercial payers additional information needed to process a claim. This includes HCPCS Level I (Physicians’ Current Procedural … Continue reading

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How to Avoid Common Medical Billing Compliance Pitfalls?

There are several major issues facing compliance officers today, such as HIPAA, Stark Law, and Anti-kickback Statute issues, as well as many billing compliance issues. Billing issues continue to appear in federal government False Claims Act settlement agreements and government … Continue reading

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Prior Authorization and It’s Impact on Practice Collection

Prior authorization is a check run by some insurance companies or third-party payers before they will agree to cover certain prescribed medications or medical procedures. There are a number of reasons that insurance providers require prior authorization, including age, medical … Continue reading

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