decisionhealth Newsletters, Part B News - 2014 Issue 7 (July)
Increase your billing success: Let billing staff be experts on payer policies
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Article Overview
This article is for medical coders, billers, and practice managers who want to improve claims handling and reduce lost reimbursement. It focuses on broader billing workflow design, denial tracking, communication between coding and billing teams, and handling payer-specific review and appeal processes. The discussion also references Medicare contractor guidance and payer policy awareness as part of denial management.
Why This Topic Matters
Understanding payer-specific billing workflows can help practices spot denial patterns sooner, improve internal communication, and reduce avoidable rework. For organizations that manage claims across multiple payers, the article highlights operational approaches that may support cleaner submissions and more organized appeals handling.
Article Sections
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Denials management
Introduces the article’s focus on organizing claims workflows to support denial prevention and reimbursement management. Discusses broader staffing approaches and the value of payer-specific knowledge.
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3 tips to handle claim denials
Presents practical workflow considerations for addressing denied claims, including prioritization, carrier communication, and appeal follow-up. The section centers on process improvement across billing operations.
What You Will Learn
- How payer-focused billing assignments can support denial management
- Why communication between coding and billing teams matters
- How practices can organize denial work across specialties and payers
- What to consider before contacting a carrier about a claim review
- How appeal tracking and follow-up fit into billing workflow
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle staff
- Practice managers
- Billing supervisors
- Compliance and reimbursement teams
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