Insurance claim rejections and its followup Invalid member name, date of birth or identification number Policy canceled or coverage terminated Invalid or obsolete ICD 10 diagnosis code Non specific ICD…
E&M code updates of 2021 Medicare and Medicare Advantage plans are adopting the new E&M codes starting from 01/01/2021. However commercial insurances usually follow CMS and AMA guidelines, they are not…
How to avoid medical records request from United Healthcare United Healthcare requests medical records for most of the claims. After our deep analysis we found that if the total claim…
Fee schedule analysis and auditing The insurance allowed amount or the fee schedule is determined by various factors such as…
Medical coding certification: Certified Professional Coder (CPC) The CPC certification validates proficiency in the correct application of CPT, HCPCS Level II procedure and supply codes, and ICD-10-CM diagnosis codes used…
Provider directory It is profile which shows the healthcare provider information in a directory structure on the healthcare payer’s website. Information like providers name, specialty, servicing address, phone and fax…
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