Course | Overview | Denials Management
This course defines claims denial management and explains the impact of claims denials on hospitals. It highlights the benefits to hospitals of managing claims denials effectively and describes how claims denials can be managed both before ...
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Course | Overview | Denials Management
This course explains how improving management of the claims denial process can have a positive effect on a hospital's bottom line. It presents best practices that will help to capture a significantly higher proportion of claims and increase...
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Course | Overview | Denials Management
This course addresses the different types of health plan rejections and typical reasons for claim rejections. It will review typical billing errors and how to avoid them. It covers the reasons for health plan denials and how to address and ...
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Course | Overview | Denials Management
This course addresses follow-up procedures for unresolved health plan and liability payer, also known as third-party payers, accounts and common account resolution procedures and activities specific to lien issues.
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Course | Overview | Denials Management
This course introduces the idea that lasting performance improvement in the revenue cycle can only be achieved after changing the work culture. The course also describes the ambulatory payment classification (APC) system introduced by the C...
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How To | Denials Management

3 abilities every coder should possess

How To | Denials Management

3 abilities every coder should possess

The onus is on coders to be prepared to deal with the challenges that impact reimbursement and to provide insight beyond that required for basic coding.

Coders need to understand billing expectations, how the billing process works and how the revenue cycle is affected. Many are learning on the job through payer websites, coding guidelines and queries to the American Hospital Association (AHA) Coding Clinic.

The three abilities every coder should possess to do the job are:

  • Respond to denials based on payer regulations and documentation that supports the services being denied.
  • Make adjustments in the coding and address issues to mitigate or overturn
    a denial.
  • Review patterns and identify issues to determine how to move from denial management to prevention.

See related article: Know your denials challenges before developing prevention strategies

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