Billing & Credentialing Cranberry Twp. (Pittsburgh)
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Denials

Denial Management Decoded: Challenges, Strategies, and Success

December 5, 2024 / admin / Articles, Claim Denial, Claim Denial Prevention, Claim Denials, Denial Management, Denial Management Process, Denial Prevention Strategy, Denials, Denied Claims, Denied Medical Claims
Denial Management Resource

Denial management isn’t just a bureaucratic process; it’s a critical battlefield where organizations fight to protect their financial health, reputation, and operational efficiency. Whether you’re in healthcare, insurance, or any industry dealing with complex claim submissions, understanding denial management can mean the difference between thriving and merely surviving. The Fundamentals: Unpacking Denial Management At its […]

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Claim Denial, Claim Denial Prevention, Claim Denials, Denial Management, Denial Management Process, Denial Prevention Strategy, Denials, Denied Claims, Denied Medical Claims

This Halloween, Scare Away the Denied Claims!

October 24, 2024 / admin / Articles, Claim Denial, Claim Denials, Claim Rejection, Denial Analytics, Denial Codes, Denial Management, Denial Prevention Strategy, Denials, Denials Managements, Denied Claims, Denied Medical Claims, Halloween
Halloween: Scary Denial Claims

🎃 BOO! Did that denied claim just give you a fright? Don’t worry – we’re here to help you turn those scary denials into sweet success. Just like preparing for trick-or-treaters, a little preparation goes a long way in the world of medical billing. Let’s unmask the spooky specters of denied claims and learn how […]

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Claim Denial, Claim Denials, Claim Rejection, Denial Analytics, Denial Codes, Denial Management, Denial Prevention Strategy, Denials, Denials Managements, Denied Claims, Denied Medical Claims, Halloween

Common Denial Codes in Medical Billing

October 20, 2024 / admin / Articles, Claim Denials, CO109, CO11, CO119, CO133, CO150, CO16, CO18, CO197, CO204, CO22, CO234, CO24, CO252, CO27, CO31, CO32, CO50, CO55, CO56, CO97, Coding, Common Denial Codes, Denials, Denied Claims, Eligibility Denial Codes, Medical Necessity Denial Codes, Payer-Specific Denial Codes, Registration Denial Codes
Denial Management Resource

Medical billing is a complex process that requires precision, attention to detail, and a thorough understanding of various codes and regulations. One of the most frustrating aspects of this process is dealing with claim denials. These denials can occur for numerous reasons, often represented by specific denial codes. Knowledge of these codes is crucial for […]

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Billing Denial Codes, Claim Denials, CO109, CO11, CO119, CO133, CO150, CO16, CO18, CO197, CO204, CO22, CO234, CO24, CO252, CO27, CO31, CO32, CO50, CO55, CO56, CO97, Coding, Common Denial Codes, Denials, Denied Claims, Eligibility Denial Codes, Medical Necessity Denial Codes, Payer-Specific Denial Codes, Registration Denial Codes

From Denials to Dollars: Effective Appeal Strategies

October 15, 2024 / admin / Articles, Denial Codes, Denial Management, Denial Management Process, Denial Prevention Strategy, Denial Trends, Denial vs Rejection, Denials, Denied Claims, Denied Medical Claims
Denial Management Resource

Denials are an unfortunate reality, in the world of insurance claims and medical billing. However, a denial doesn’t have to be the end of the road. With the right approach and effective appeal strategies, it’s possible to turn these denials into approvals and recover rightful reimbursements. We’ll explore the art and science of appeals, providing […]

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Denial Codes, Denial Management, Denial Management Process, Denial Prevention Strategy, Denial Trends, Denial vs Rejection, Denials, Denied Claims, Denied Medical Claims

Denial Management in RPA Billing

September 10, 2024 / admin / Articles, Denial Management, Denial Management Process, Denial Prevention Strategy, Denial Trends, Denials, Denied Claims, HL7, HL7 FHIR, HL7 Interface, HL7 messaging, HL7 Standards, Robotic Process Automation, RPA
Denial Management Resource

In recent years, Robotic Process Automation (RPA) has emerged as a game-changing technology in healthcare revenue cycle management, particularly in the realm of denial management. The promise of RPA to streamline processes, reduce errors, and improve efficiency has led many healthcare organizations to invest heavily in automating their billing and denial management workflows. However, the […]

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Denial Management, Denial Management Process, Denial Prevention Strategy, Denial Trends, Denials, Denied Claims, HL7, HL7 FHIR, HL7 interface, HL7 messaging, HL7 Standards, Robotic Process Automation, RPA

Handling Denied Claims and Appeals in Medical Billing

April 24, 2024 / admin / Articles, Denial Analytics, Denial Codes, Denial Management, Denial Management Process, Denial Prevention Strategy, Denial Trends, Denial vs Rejection, Denials, Denied Claims, Denied Medical Claims, Medical Billing

Denied medical claims represent one of the most significant challenges in healthcare revenue cycle management. These rejections create financial strain, operational inefficiency, and resource allocation issues that require systematic resolution processes. Industry data indicates denial rates ranging from 5-10% on average, with certain specialties experiencing rates of 20-30%. A denied claim occurs when an insurance […]

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Denial Analytics, Denial Codes, Denial Management, Denial Trends, Denied Claims, Denied Medical Claims

Mastering Charge Capture: A Roadmap for Healthcare Providers

April 13, 2024 / admin / Articles, Automation, Billing, Billing Automation, Charge Capture, Charge Capture Challenges, Charge Capture Strategy, Coding, Coding and Billing, Denials, EHR, EMR, Missed Charges, Optimized Charge Capture, Revenue Leakage
Charge Master Work

If you’re a healthcare provider, you know how important it is to get paid accurately and on time for the services you provide. But the revenue cycle management process can be a tangled web of codes, documentation requirements, and insurance rules. One of the biggest pain points? Charge capture. Charge capture is the process of […]

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Billing, Charge Capture, Charge Capture Challenges, Charge Capture Strategy, Denials, EHR, EMR, Medical Billing, Missed Charges, Optimized Charge Capture, Revenue Cycle Management, Revenue Leakage

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Practices Served

  • Behavioral Health
  • DME
  • Urgent Care
  • Speech Therapy
  • Geriatric Medicine
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Genetic Testing
  • Pharmacogenetic (PGx)
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

Practices Served

  • Behavioral Health
  • DME
  • Urgent Care
  • Speech Therapy
  • Geriatric Medicine
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Genetic Testing
  • Pharmacogenetic (PGx)
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

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