decisionhealth Newsletters, Part B News - 2010 Issue 7 (July)
5 steps to get proper payments after claims were processed with 21.3% cut
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Article Overview
This article covers how a physician practice organized its accounts receivable and claim follow-up process after claims were processed under a reduced Medicare fee schedule and later needed reprocessing. It is aimed at billing staff, patient account managers, and practice administrators who need a general overview of post-processing claim management, coordination with secondary payers, and patient account handling during a reprocessing event.
Why This Topic Matters
It helps revenue cycle and billing teams understand the operational issues that can arise when already-processed claims must be reworked under updated payment rates, including downstream effects on secondary claims and patient statements.
What You Will Learn
- How a practice can organize claims affected by Medicare reprocessing
- How related secondary payer claims may be managed during payment adjustments
- How patient account activity may be temporarily controlled while payments are being corrected
- How billing teams may monitor whether adjusted payments have been received
Who Should Read This
- Medical billers
- Revenue cycle staff
- Patient account managers
- Practice administrators
- Primary care billing staff
- Rheumatology practice staff
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