Medical Billing Blog: Section - Denials

Archive of all Articles in the Denials Section

This is the archive containing links to all articles written in the Denials section of our blog.

Click any of the article links below to read the entire article or browse another section to the right to read articles on another subject.

Outsourcing a Dirty Word toYou?

The word “outsourcing” has become a dirty word for many physicians that have been burned by medical billing companies that either outsourced their claims to medical billing companies that use neither secure networks nor adhere to HIPAA regulation in order to maximize their profits; or the outsourcing company just turned out to not be reliable and it wound up costing the practice money to utilize their services. Don’t let a bad experience keep you from partnering with a legitimate medical billing company that can not only help you get your reimbursements faster but also realize great profits by maximizing every single medical billing claim that is filed to make sure

By: Melissa Clark, CCS-P, RT - CEO
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October Updates Are In Effect!

If you haven’t already, make sure that your staff is using the updated CPT codes that were released in October 2008. Not doing so can lead to kick backs that will require more staff hours to research, redo and resubmit and if this happens on a number of claims it can seriously affect your reimbursements and in turn – slow your revenue flow to a mere trickle. One way to avoid this dilemma is to outsource your medical billing and yes, there are some horror stories out there about outsource companies that threw away patient billing, had lax attitudes towards billing submissions and wound up costing the physician a lot

By: Melissa Clark, CCS-P, RT - CEO
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Tips for Getting Maximum Reimbursements for Ulcer Claims

Often, patients who are confined to beds for long periods of time develop pressure ulcers. They are painful and need to be treated as quickly as possible as infections can set up within them that can be life threatening when the patient is already in a weakened condition. When a service is performed for a patient such as treatment of a pressure ulcer on an area of the body such as the lower back, the usual manner of treatment is to remove any devitalized tissue from the ulcer using a water jet and forceps. The area is then covered to allow it to not be rubbed on so the skin

By: Melissa Clark, CCS-P, RT - CEO
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Common Varicose Vein Treatments

As more research is done regarding the relationship between varicose veins, blood clots and other complications; more and more patients are having the simple surgery and as a result there has been confusion about exactly how to code this procedure to get the fairest reimbursement for this service. Once you know the basics for setting it up – it’s easy! A good example would be if a patient with varicose veins in her left lower leg presents to the ED and is stating she has severe pain in her leg. One of the veins is clearly bleeding so the doctor will use a standard suture ligation to stem the bleeding

By: Melissa Clark, CCS-P, RT - CEO
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Do You Know the Three "R’s" of Consulting Reimbursements?

Since consultation requirements have increased in the last year as far as criteria for getting them reimbursed in your medical billing claims, there are some criteria you must be certain that your claims meet in order to justify using codes 99241-99255. It used to be simple and medical billing consultant merely had to meet the three “R’s” in order to justify medical billing claims for consultations. However the criteria for what does and does not constitute a consultation has changed and in order to make sure that your medical billing claims are paid, you need to reacquaint yourself with the three R’s of medical billing for consultations. The three R’s

By: Melissa Clark, CCS-P, RT - CEO
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Medical Billing for TB Screenings Made Easy

TB is in the news more and more and if you aren’t already seeing an increase in TB screenings, it’s likely your practice could experience it in the future. If you have a medical billing claim involving a patient that is at an increased risk for tuberculosis (TB) infection or is already having symptoms, a TB screening can be performed. If your practice runs these tests, be aware that in many cases, you can get reimbursed for the test as a medical necessity. When processing the medical billing for a TB skin test (86580) or blood test (86480) due to pulmonary TB symptoms or known TB exposure or risk. The

By: Melissa Clark, CCS-P, RT - CEO
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