decisionhealth Newsletters, Part B News - 2013 Issue 8 (August)
Close coder-biller communication is key to prevent repeat denials
Subscribe or sign in to view the full article.
Article Overview
This article covers workflow and communication practices that can help medical offices identify denial patterns, respond to claim denials, and manage audit-related requests more effectively. It is aimed at coders, billers, practice managers, and administrators who handle claims, denials, and appeals, with discussion of broader operational issues such as denial tracking, internal review, resubmission, and coordination with payers and carriers.
Why This Topic Matters
Repeated denials can create administrative burden, delay payment, and signal underlying coding, documentation, or process problems. Understanding the article can help practices evaluate internal communication and denial-management processes.
Article Sections
-
Physician payments
An overview of the article’s focus on payment-related workflow and the relationship between coding and billing operations.
-
Keep the front end informed of claim denials
Discussion of how denial information should circulate within a practice and why recurring denial patterns matter for internal follow-up.
-
The easy fix: Resubmission
General guidance on handling minor claim issues, correcting filings, and considering internal review when similar denials appear repeatedly.
-
Never a fix: Finding a code that pays
A cautionary section about denial scenarios that are unlikely to be resolved by simple resubmission or by changing claim information after denial.
-
Designate a point person for audits, denials
Discussion of assigning responsibility for denial and audit follow-up, along with the role of regular review and communication within the practice.
What You Will Learn
- How communication between billing and coding teams can affect denial management
- Why recurring denials should be tracked and reviewed internally
- General approaches to handling claim denials, resubmissions, and appeals
- How practices can organize responsibility for audits and denial follow-up
Who Should Read This
- Medical coders
- Medical billers
- Practice administrators
- Office managers
- Revenue cycle staff
- Physician practice leadership
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com