Diagnosis linking on a claim is the field payers read to decide medical necessity. Here is how Item 24E and 837P SV107 work and what to fix first.
Linking Diagnosis to Procedure: The Pointers That Deny Claims Read More »
The clean claim rate moves before days in A/R does. Here is the HFMA formula, the reject codes behind a low rate, and a target you can defend.
Clean Claim Rate: The Number That Predicts Your A/R Read More »
Why coordination of benefits denials arrive months late, what the reason codes mean, and how to work an open Medicare Secondary Payer case.
COB Denials: When Two Payers Each Think the Other Is Primary Read More »
Build the expirables register: what to track, the renewal windows that matter, who owns each document, and the twice-a-year payer file check.
Tracking Licenses, DEA and Board Certificates Before They Expire Read More »
Payer reviewers read behavioral health assessment documentation for named instruments, dated scores and a plan that supports the units billed.
Assessment Documentation That Survives a Payer Review Read More »
