E/M coding leveling runs on medical decision making or total time, one basis per encounter. Here is how each works and what the note has to show.
E/M Coding: Leveling by Time or Medical Decision Making Read More »
How to post an 835 ERA: group codes, the reason codes worth a write-off and the ones worth an appeal, and why unapplied cash builds when posting lags.
ERA 835 vs Paper EOB: Getting Payment Posting Right Read More »
Define initial denial rate, denial write-off rate, appeal rate, overturn rate, days to appeal and denial A/R aging, and which way each should move.
The Denial KPIs That Actually Move Revenue Read More »
Medicare, Medicaid and commercial credentialing timelines with the rules behind them, the four events that restart the clock, and how to sequence enrollment.
How Long Payer Credentialing Really Takes Read More »
A behavioral health carve out sends eligibility, prior authorization and claims to a different company. Here is how to route them correctly the first time.
Behavioral Health Carve-Outs: When the Payer Is Not the Payer Read More »
