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.
Diagnosis Linking Claim Errors That Trigger Denials 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.
Coordination of Benefits Denial: Two Payers, One Claim 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.
Credentialing Expirables: Track Licenses, DEA, Boards Read More »
Payer reviewers read behavioral health assessment documentation for named instruments, dated scores and a plan that supports the units billed.
Behavioral Health Assessment Documentation: Payer Review Read More »
