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Communicating with healthcare payers is a process, one involving more than simply handing them a medical claim. Here are some tips to help with the process. Creating better relationships with your payers before Oct. 1, in fact, enables providers to glean important insights about testing results, changes to reimbursement, how to handle denied claims. Early…
DetailsR45.1 — Restlessness and agitation R45.2 — Unhappiness R45.3 — Demoralization and apathy R45.4 — Irritability and anger In preparation for the upcoming deadline for ICD-10 implementation, RT Welter presents weekly ICD-10 Codes of the Week! Our goal is to familiarize you with the new and expanded code set and the additional clinical documentation needed…
DetailsYour providers see waste in the system every day. Services that are done (by other providers and facilities), but not needed for a particular patient’s care—Make note of these! Use them when you sit down to re-negotiate your next rate increase with the payers. You don’t need the specific patients (this is protected information), you…
DetailsIn most markets half, or more, of the payer lives are in self-funded plans This means the “insurance company” is not really providing an Insured Product—they simply administer the plan. The actual payer, at the end of the day, is the employer themselves. All of these employers have a Human Resources Department (or something similar)…
DetailsThe United States Senate just passed the SGR Bill, which includes no indication of a further delay of the ICD-10 transition deadline. In a move that took over a decade to accomplish, the Senate voted 92-8 late Tuesday to repeal the sustainable growth rate (SGR) formula that adjusts Medicare payments to physicians. The bill, H.R.…
DetailsThis interactive and hands-on ICD-10 training is designed to prepare coders for the AAPC and AHIMA ICD-10 proficiency examinations. This training is also appropriate for experienced billers that perform coding as part of their job responsibilities. Participants will gain the tools they need to appropriately select ICD-10-CM codes. These training sessions will be coder centric,…
DetailsJ30.1 — Allergic rhinitis due to pollen
J30.2 — Other seasonal allergic rhinitis
J30.81 — Allergic rhinitis due to animal (cat) (dog) hair and dander
J30.89 — Other allergic rhinitis
Do you know the payer representatives? Find out who they are and develop a relationship! Usually there is someone assigned to you. Invite them to drop in for lunch. They are not the enemy and very often a good relationship can pay big dividends when you need help with a problem claim, or when it…
DetailsThe US Senate has recessed without taking up the Doc Fix We were so close to finally doing away with the SGR (Sustainable Growth Rate) calculation which has held good medical care hostage year after year. The House of Representatives sent through a bi-partisan bill to the Senate, the President was ready to sign, and the…
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