Etactics

NOVEMBER 3, 2022

30% of insurance claims get denied on their first submission. Part of this is because of the complicated nature of the claim adjudication process. There’s nothing simple about the claim submission process. If you aren’t a seasoned medical biller, you are probably asking yourself, “what is claim adjudication?”

Healthcare Providers 52

Healthcare Providers Prevention Healthcare Accountability 52

Etactics

AUGUST 30, 2022

You submit a patient’s claim to their insurance payer, their payer takes a look at it and they pay you. Although that statement is technically true regarding the claim submission process, it’s definitely not easy. After all, there’s a reason why 30% of insurance claims get denied on their first submission. Easy enough, right?

Healthcare 52

Healthcare Accountability Nursing 52

Etactics

JANUARY 26, 2024

In this blog, we focus on unveiling the details surrounding the fee-for-service payment model. Details include what it is, how it works, as well as criticisms that surround the practice. Quality of care. So the question becomes, “Why is this method popular?” After all, there are some noteworthy models other than fee-for-service.

Healthcare 52

Healthcare Primary Care Medicare Healthcare Providers 52

Etactics

FEBRUARY 10, 2023

There are between 5 and 10 percent medical claim denials on average, according to the AAFP. In 2020, across HealthCare.gov insurers, reports show that 18 percent of in-network claims resulted in claim denials. But what are denial codes? Table of Contents What are Denial Codes? Let’s dive in.

Healthcare 52

Healthcare Healthcare Providers Medicaid Prevention 52

Etactics

SEPTEMBER 20, 2022

86% of all healthcare claim denials are avoidable. Of course, the true answer to that question is that healthcare claim submission isn’t cut and dry. After all, healthcare is in the “business” of treating patients…not catering to the claim submission requirements set forth by insurance providers. What is denial code CO16?

Medicare 52

Medicare Healthcare Prevention Hospitals 52

Etactics

SEPTEMBER 7, 2023

There were nearly 50 million denied healthcare claims in 2021. Based on the total number of in-network claims submitted, that averaged out to a 17% denial rate. I know what you’re thinking, “That was back in 2021, right after a pandemic. That’s just one of the key topics we’re going to cover in this blog.

Healthcare 52

Healthcare Doctors Prevention Medical Services 52