Compliantly Optimize Healthcare Reimbursements
Denials and underpayments are defects in the revenue cycle that indicate a provider’s inability to comply with payer requirements or a payer’s inability to accurately pay a claim. CRN Healthcare Solutions works with practices to evaluate and implement lean process workflow denials management so that every dollar not paid which should have been paid is addressed and followed up.
How to Document E/M with Counseling and Coordinating Care
The only case when time may be used as the overriding factor in determining an evaluation and management (E/M) level is when counseling and/or coordinating care dominates the encounter, which means that the time expended on counseling and/or coordinat… For more,...
Understand Clearing Houses
Clearing houses affect revenue flow through denials. Understanding them and their processes helps you speed your re-submissions. After a claim file is sent to the clearinghouse, an edit report is sent back to the practice, indicating claims and charg… For more,...
Modifiers 52 and 53 vs. 73 and 74
Modifier 52, Reduced Services and Modifier 53, Discontinued Procedure apply to physician services while Modifiers 73 and 74, Discontinued Out-Patient Hospital/Ambulatory Surgery Center (ASC) Procedure Prior to the Administration of Anesthesia and Disc… For more,...
E/M Documentation by Med Students Rules Clarified
The Centers for Medicare & Medicaid Services (CMS) issued a MLN Matters article ( MM10412 Revised) on May 31 with a retroactive effective date of January 1, 2018 clarifying documentation requirements when performed by Medical Students in a teac… For more,...