Billing & Credentialing Cranberry Twp. (Pittsburgh)
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  • Denied Medical Claims

Denied Medical Claims

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

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

Handling Denied Claims and Appeals in Medical Billing

April 24, 2024 / admin / Articles, Denial Analytics, Denial Codes, Denial Management, Denial Trends, Denials, Denied Claims, Denied Medical Claims, Medical Billing

Dealing with denied medical claims is one of the biggest headaches in the healthcare revenue cycle. It’s frustrating, time-consuming, and can put a serious dent in your bottom line if not handled properly. But fear not – we’re here to walk you through the process of identifying denials, filing appeals, and hopefully getting those claims […]

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Denial Analytics, Denial Codes, denial management, Denial Trends, denied claims, denied medical claims

Claim Denial Kryptonite: Specialty-Specific Strategies to Supercharge Your Revenue Cycle

March 26, 2024 / admin / Articles, Claim Denials, Coding, Coding and Billing, Denial Kryptonite, Denial Management, Denied Claims, Denied Medical Claims, Diagnosticians, E&M code, Interventionists, Lex Luthor, Medical Billing, Proceduralists, RCM, Revenue Cycle, Revenue Cycle Management, Superman, Therapists
Denial Kryptonite

Let’s face it – claim denials are the bane of every medical practice’s existence. They’re like kryptonite sapping the strength from your revenue cycle. But what if we told you there was a way to turn those denied claims into a money-making superpower? No, we’re not peddling some snake oil solution. I’m talking about adopting […]

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billing, Claim Denial Kryptonite, Coding, coding and billing, Denial Kryptonite, Diagnosticians, E&M code, Interventionists, Kryptonite-Proof Strategy, Lex Luthor, Proceduralists, rcm, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Management (RCM), Therapists

Mastering Denial Management: Tactics for Maximizing Reimbursements

March 14, 2024 / admin / Articles, Billing, Claim Denial, Claim Denial Prevention, Continuous Process Improvement, Data Analytics, Denial Analytics, Denial Management, Denial Prevention Strategy, Denial Trends, Denied Claims, Denied Medical Claims, Disrupted Cash Flow, Medical Billing, Revenue Leakage
Denial Management Resource

Denial management has emerged as a critical component for healthcare providers and organizations. As payers become more stringent in their reimbursement policies and regulatory requirements tighten, effective denial management strategies are essential for minimizing revenue leakage and ensuring financial stability. According to industry reports, up to 90% of denied claims are recoverable, representing a significant […]

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Administrative Burden, billing, claim denial prevention, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Continuous Process Improvement, Denial Analytics, Denial Codes, denial management, Denial Prevention Strategy, Denial Trends, Denials Managements, denied claims, denied medical claims, Disrupted Cash Flow, Patient Dissatisfaction

Claim Denial vs. Rejection: What’s the Difference?

February 23, 2024 / admin / Articles, Claim Denial, Claim Denial Prevention, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Claims Management, Clearinghouse Rejection, Denial Management, Denial Prevention Strategy, Denial Trends, Denial vs Rejection, Denied Claims, Denied Medical Claims, Payer Rejection, Rejected Claims
Medical Claim Denied Doctor

In the healthcare industry, there are two main ways that insurance companies respond when they decide not to pay a claim – denial and rejection. Both indicate the claim will not be paid, but there are some important differences between the two. Understanding the distinction is critical for medical providers to correctly follow-up so they […]

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Claim Denial, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Clearinghouse Rejection, Denial vs Rejection, denied claims, healthcare, Healthcare Billing, Medical, Medical Billing, Payer Rejection, rcm, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization

Strategies for Dealing with Denied Claims

February 21, 2024 / admin / Articles, Billing, Claim Denial Prevention, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Denial Analytics, Denial Codes, Denial Management, Denial Prevention Strategy, Denial Trends, Denials Managements, Denied Claims, Denied Medical Claims

Dealing with denied claims is one of the most frustrating and time-consuming aspects of medical billing. However, there are several strategies billing staff can employ to efficiently handle denials, appeal them successfully, and prevent denials from occurring in the first place. We analyze the most effective ways to deal with denied claims in medical billing. […]

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billing, claim denial manager, Claim Denials, Claim Rejection, Claim Rejection Rate, denial management, Denial Prevention, Denial Prevention Strategy, Denial Trends, Denials, denied claims, Healthcare Billing, Medical Billing, rcm, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization

Top Strategies to Drastically Reduce Claim Denial Rates in 2024

February 5, 2024 / admin / Appeals Management, Articles, Claim Denial Prevention, Claim Denial Rate, Claim Denials, Claim Rejection, Denial Management, Denial Trends, Denied Claims, Denied Medical Claims, Medical Necessity, Patient Insurance Eligibility, Pre-certifications, Preventable Denial Rates, Reducing Denials
Medical Claim Denied Doctor

Claim denials continue to be a persistent challenge for healthcare providers in 2024. The costly administrative burden of denied claims and appeals, coupled with lower revenues and margins, puts increasing pressure on organizations to find ways to prevent denials and increase collections. The good news is there are proven strategies providers can implement to proactively […]

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Appeals management, Authorizations, claim denial prevention, denial rates, documentation, medical necessity, patient demographic/insurance data, patient insurance eligibility, Pre-certifications, preventable denial rates, Reducing Denials, verification

Navigating the Rise in Denials: Strategies for Successful Denial Management in Medical Billing

November 17, 2023 / admin / Articles, Data Management, Denial Codes, Denial Management, Denial Prevention Strategy, Denial Trends, Denied Claims, Denied Medical Claims
Rejected, Denied Medical Claim

As healthcare payers implement more rigorous utilization management programs, denial rates on medical claims have been steadily climbing – up to nearly 10-15% on average for practices based on reports. Denials directly impact revenues and practice bottom lines due to the costs of reworking and appealing claims. We offer an overview of building a denial […]

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Claim Denials, Denial Codes, denial management, Denial Prevention Strategy, Denial Trends, denied medical claims, healthcare, Healthcare Billing, Medical Billing, Medical Billing Service, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization

Growing Risk of Claim Denials: How to Protect Your Practice

October 6, 2023 / admin / Articles, Billing, Billing Denied Claims, Claim Denials, Claim Rejection, Claim Status, Claim Status Updates, Denial Codes, Denial Management, Denial Prevention Strategy, Denial Trends, Denied Claims, Denied Medical Claims, RCM, RCM Challenges, Revenue, Revenue Cycle Management, Revenue Integrity, Revenue Leakage
Medical Claim Denied

For medical practices, claim denials have always been a fact of life when dealing with health insurers. However, trends show claim denial rates growing year over year, driven by increased utilization management efforts by payers. Denials directly impact practice revenues and the time/costs tied to appealing denials. Below, we take a gander at the factors […]

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Claim Denials, Denial Codes, Denial Prevention Strategy, Denial Trends, Denials, denied medical claims, healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Service, Revenue Cycle Management, revenue cycle optimization

Which CPT Codes are Used in Hospitalist Billing?

August 2, 2023 / admin / Articles, Billing, Billing Revenue, Billing Services, Claim Billing, Claim Data, Claim Denials, CPT Codes, Denial Management, Denied Claims, Denied Medical Claims, Healthcare, Healthcare Billing, HL7, Hospitalist, Hospitalist Billing, Hospitalist Medicine, ICD-10, Medical, Medical Billing
Medical Billing Software White Male User

In the realm of medical billing and coding, precision and accuracy are paramount. Hospitalist billing, a specialized area, relies on specific CPT (Current Procedural Terminology) codes to ensure proper reimbursement for services rendered. These codes serve as a universal language that communicates medical procedures and services to insurance companies. In this comprehensive guide, we’ll delve […]

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99221, 99231, 99233, 99238, CPT codes, CPT Codes in Hospitalist Billing, healthcare, Healthcare Billing, Hospitalist, Hospitalist Billing, Hospitalist Medical Billing, ICD-10, Medical, Medical Billing, Medical Billing Service

Denial Codes in Medical Billing: A Comprehensive Guide

May 21, 2023 / admin / Articles, Billing, Billing Best Practice, Billing Services, Claim Billing, Claim Denials, Claim Rejection, Claim Status, Denial Codes, Denials Managements, Denied Claims, Denied Medical Claims, Rejected Claims
Rejected, Denied Medical Claim

Welcome to our comprehensive guide on denial codes in medical billing. As a leading authority in the healthcare industry, we understand the challenges healthcare providers face when it comes to navigating the complex world of medical billing. Our goal is to provide you with valuable insights and actionable strategies to help you overcome denial code challenges […]

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Denial Codes, denial management, denied medical claims, healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Service, outsourced billing, Revenue Cycle Management, revenue cycle optimization

Qualities of an Outstanding Physician Billing Solution

May 5, 2023 / admin / Articles, Artificial Intelligence, Billing, Billing AI, Billing Automation, Billing Best Practice, Billing Revenue, Billing Services, Claim Billing, Denied Claims, Denied Medical Claims, EHR, EHR Integration, Electronic Claims, Healthcare, Healthcare Billing, HIPAA Compliant, HL7, Medical, Medical Billing, Robotic Process Automation, RPA, RPA HL7
Medical Billing Software White Male User

As a leading provider of healthcare services, we understand the importance of an efficient and reliable physician billing solution. Medical billing is a critical aspect of healthcare management, and selecting the right solution can significantly impact the success and profitability of a practice. In this article, we will explore the key qualities that define a […]

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billing, denial management, EHR, Electronic Health Records, healthcare, Healthcare Billing, HL7, Medical, Medical Billing, Robotic Process Automation, Robotic Process Automation Medical Billing, RPA

Why Do Insurance Companies Deny Medical Claims?

February 2, 2023 / admin / Articles, Billing, Billing Denied Claims, Billing Revenue, Claim Billing, Claim Denials, Denied Claims, Denied Medical Claims
Rejected, Denied Medical Claim

Insurance Companies Deny Medical Claims for a Number of Reasons Insurance Claim Denials Can be Challenging As a patient, it can be frustrating to have your medical claim denied by your insurance company. Unfortunately, this is a common issue that many people face. In this section, we’ll explore some of the reasons why insurance companies […]

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The Crucial Role of Medical Billing in Healthcare

February 1, 2023 / admin / Articles, Billing, Billing Denied Claims, Billing Revenue, Claim Billing, Claim Denials, Claim Rejection, Denied Claims, Denied Medical Claims, EHR, EHR Integration, EMR, EMR Integration, Full Service Medical Billing, Healthcare, Healthcare Billing, HIPAA, Medical, Medical Billing, Medical Billing Companies, Robotic Process Automation, RPA
electronic-claim-attachments

Medical Billing: Basics, Role of Specialists, Challenges, RPA and What to Look for in a Company Medical billing is an important aspect of the healthcare industry that plays a crucial role in ensuring that patients receive the medical treatment they need while healthcare providers are reimbursed for the services they offer. The process involves submitting […]

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Billing Accuracy, HIPAA, HIPAA Compliant, Medical Billing, Medical Billing Compliance, Medical Billing Customer Service, Medical Billing Expertise, Medical Billing Robotic Process Automation, reimbursement rates, Robotic Process Automation, RPA

Struggling with Claim Denials?

December 28, 2022 / admin / Articles, Billing, Billing Denied Claims, Claim Billing, Claim Denials, Claim Rejection, Denials Managements, Denied Claims, Denied Medical Claims, Medical Billing, Medical Claim Denials, Medical Claim Rejection, Medical Claims, Medical Payor

Overcome Claim Denials Claim Denials are Challenges for Healthcare Providers Even healthcare providers who deploy safeguards to dodge insurance payment hazards, occasionally find themselves up against a claim denial. Taking care of denied insurance claims can be a frustrating process for healthcare practitioners and their office staff. That’s why it’s vital to utilize a claim […]

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billing, Claim Denial, Claim Denials, Claim Rejections, denial management, denied medical claim prevention, denied medical claims, healthcare, Healthcare Billing, Medical, Medical Billing, Medical Claim Rejections, medical claims, Medical Payor, rcm, Revenue Cycle Management

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Practices Served

  • Behavioral Health
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  • Toxicology
  • COVID-19 Testing
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  • Skilled Nursing Facilities
  • Urgent Care
  • Oncology
  • Pathology
  • OBGYN
  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Speech Therapy
  • Substance Abuse
  • DME
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy

Recent Posts

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  • Medical Credentialing Staff at a Hospital

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    Credentialing Problems? We Can Fix Them!

  • Medical Credentialing State-by-State

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