How to sample charts by provider and code family, score errors against Medicare’s five CERT categories, and turn the findings into fewer denials.
Internal Coding Audits: Sampling, Scoring and Follow-Up Read More »
Five diagnostics drive the outsourcing medical billing decision: claim volume, payer mix, denial composition, staff turnover and cost per collected dollar.
When to Outsource Billing: A Decision Framework Read More »
A duplicate claim denial usually means the original claim is still in adjudication. Check status first, then correct the claim instead of refiling it.
Duplicate Claim Denials: Why Resubmitting Makes It Worse Read More »
Type 1 and Type 2 NPIs do different jobs on a claim. Which number belongs in item 24J, which belongs in 33a, and what reassignment changes.
Group NPI vs Individual NPI: Where Claims Get Lost Read More »
Place of service, modifiers and audio-only rules differ across Medicare, commercial payers and state Medicaid. Here is how to verify each before the visit.
Behavioral Health Telehealth Billing by Payer and State Read More »
