Etactics

JANUARY 18, 2023

This amounts to over 200 million claim rejections each day! There are ways you can avoid claim rejections and thus keep your revenue flowing. Knowing the different denial codes and what they stand for is just part of the equation. What is a denial code? What is denial code CO 45? What is a denial code?

Healthcare 52

Healthcare Healthcare Providers 52

Etactics

APRIL 13, 2023

It’s probably due to the hundreds of denial codes that aren’t technically standardized across all payers. But have no fear, there are some denial codes that are more common than others and by familiarizing yourself with them, you could save yourself some hassle in the future! Let’s look at the common denial code PR 204!

Regulations 52

Regulations Nursing Prevention Healthcare 52

Etactics

SEPTEMBER 1, 2023

The Importance of The Right Clearinghouse Conclusion Defining Healthcare Claims and Remittances If you held a conversation with a claims clearinghouse or a medical biller about the revenue cycle. That scenario we just briefly walked through is one of the main reasons why healthcare organizations seek the services of clearinghouses.

Healthcare 52

Healthcare Accountability Healthcare Providers Doctors 52

Etactics

JANUARY 18, 2022

That’s exactly what this blog post covers. Table of Contents Step 1: Credentialing Preparation Step 2: Credentialing Application Step 3: CPT Codes You Need to Know Step 4: Claim Submission Step 5: Post-Submission and Appeals Conclusion. Instead, all you need to do is figure out how to bill insurance companies for counseling.

Private Practices 52

Private Practices Tricare Accountability Medicaid 52

Etactics

NOVEMBER 3, 2022

Improving the claim adjudication process Utilizing Automation Front-End Edits and Coding Checks Standardization of Claim Adjudication Selecting The Right Clearinghouse Payer Connections Claim Scrubbing Predicting Claim Status Conclusion. Next comes all of the CPT codes related to the primary services provided. What is a claim?

Healthcare Providers 52

Healthcare Providers Prevention Healthcare Accountability 52

Etactics

JANUARY 11, 2022

Usually, you receive a notification of the claim denial through your practice management (PM) system and your clearinghouse. Clearinghouse A clearinghouse is usually a service offered by a third-party organization that acts as a central repository and middle-man to your claim submission process.

Medicaid 52

Medicaid Integration Medicare Healthcare 52

Etactics

OCTOBER 25, 2022

For example, let’s take a look at claim rejections. What are some of the main reasons for a claim rejection? Rushed exams can cause medical coding errors, or worse, and may leave a patient feeling unheard or like they don’t matter. ICD codes and CPT codes must be correct before sending them to a payer.

Regulations 52

Regulations Doctors Healthcare Integration 52

Etactics

SEPTEMBER 7, 2023

But, in our 20+ years of business as a medical claims clearinghouse with a focus on denial management, we’ve noticed a pattern. That’s just one of the key topics we’re going to cover in this blog. The majority of denied claims come back with rejection codes that fall under the soft claim bucket. I have good news for you.

Healthcare 52

Healthcare Doctors Prevention Medical Services 52

Etactics

MAY 19, 2023

Medical billing and coding is an important piece of the revenue cycle puzzle. Ironically enough, coding errors are the top-rated concern for hospital reimbursement leaders. For instance, claim scrubbing is a service offered by experienced clearinghouse organizations that catch mistakes before you submit a claim to an insurance payer.

Healthcare Providers 52

Healthcare Providers Medicaid Healthcare Prevention 52