Coordination of Benefits (COB) is a crucial aspect of health insurance, ensuring that individuals who have coverage from multiple plans receive the maximum possible benefits without duplication. While...
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Understanding the Complexity of OON Claim Denials OON claim denials occur when a patient receives medical services from a provider that is not contracted with their insurance company. Despite being insured,...
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Workers Compensation Denials: Struggles Beyond the Injury Every RCM director and coder familiar with Workers Compensation claims knows the feeling: a sinking sensation as another denial rolls in. Processing...
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Timely Filing Deadline Denials: Babysitting the Clock Ever feel like you’re constantly putting out fires when it comes to claim denials? As a claims denial manager, you know the frustration of seeing...
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The Credentialing Process: A Team Effort to See Patients Faster Introduction The credentialing process is a critical component of healthcare that ensures providers are qualified to deliver safe and effective...
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Taxonomy Denials: The 10-Digit Code Causing Confusion Ever feel like you’re drowning in a sea of claim denials? As a claims denial manager, I see it all the time, and a surprisingly frequent offender is...
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Taking Control of Duplicate Claim Denials Duplicate claim denials are a persistent headache for healthcare Revenue Cycle Management (RCM) teams. These denials can be frustrating because sometimes they...
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Patient Referral : Challenges for PCPs and Specialists As a claims denial manager, there’s nothing quite like a perfectly coded claim getting tossed aside because of a missing patient referral. Let’s break...
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Understanding Provider-Specific Denials Provider-specific denials encompass a wide range of issues that result in the rejection of claims by payers. These denials are often unique to individual providers...
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Pre-Existing Condition Denials: What You Need to Know Let’s be frank, coders and RCM directors: pre-existing conditions are a constant source of claim denial frustration. The most maddening part? We often...
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Understanding Patient Eligibility Before providing medical services, healthcare providers must confirm that patients are eligible for coverage under their insurance plans. This process involves verifying...
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Global Period Denials: Seemingly Simple Claims Getting Rejected Every RCM director and coder has been there: a seemingly endless stream of denied claims. One of the most common reasons for these denials...
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Avoiding Procedure Code Denials RCM directors and denial managers know all too well the frustration of claim rejections stemming from procedure code issues. In the complex landscape of healthcare billing...
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Coordination of Benefits (COB) Challenges: A Shared Responsibility
Coordination of Benefits (COB) is a crucial aspect of health insurance, ensuring...
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OON Claim Denials: When In-Network Can Become Out-of-Pocket
Understanding the Complexity of OON Claim Denials OON claim denials occur when a...
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Workers Compensation Denials: Struggles Beyond the Injury
Workers Compensation Denials: Struggles Beyond the Injury Every RCM director and...
Read More ➜
Timely Filing Deadline Denials: Babysitting the Clock
Timely Filing Deadline Denials: Babysitting the Clock Ever feel like you’re...
Read More ➜
The Credentialing Process: A Team Effort to See Patients Faster
The Credentialing Process: A Team Effort to See Patients Faster Introduction The...
Read More ➜
Taxonomy Denials: The 10-Digit Code Causing Confusion
Taxonomy Denials: The 10-Digit Code Causing Confusion Ever feel like you’re drowning...
Read More ➜
Taking Control of Duplicate Claim Denials
Taking Control of Duplicate Claim Denials Duplicate claim denials are a persistent...
Read More ➜
Patient Referrals: Challenges for PCPs and Specialists
Patient Referral : Challenges for PCPs and Specialists As a claims denial manager,...
Read More ➜
Provider-Specific Denials: A Closer Look
Understanding Provider-Specific Denials Provider-specific denials encompass a wide...
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Pre-Existing Condition Denials: What You Need to Know
Pre-Existing Condition Denials: What You Need to Know Let’s be frank, coders and...
Read More ➜
Patient Eligibility: Difficulties in Verifying Patient Coverage
Understanding Patient Eligibility Before providing medical services, healthcare providers...
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Global Period Denials: Seemingly Simple Claims Getting Rejected
Global Period Denials: Seemingly Simple Claims Getting Rejected Every RCM director...
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Avoiding Procedure Code Denials: A Quick Guide
Avoiding Procedure Code Denials RCM directors and denial managers know all too well...
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