decisionhealth Newsletters, Part B News - 2017 Issue 5 (May)
Strengthen lab referrals, cut denials with focus on billing details
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Article Overview
This article covers laboratory referral and documentation practices that influence claim denials under Medicare review programs. It is aimed at billers, coders, compliance staff, and referring providers who want a high-level understanding of the documentation themes discussed in CERT and related Medicare guidance, including signatures, orders, and record support for lab testing.
Why This Topic Matters
Lab claims can be rejected when the supporting documentation is incomplete or inconsistent. Understanding the article’s compliance-focused guidance can help practices review their referral workflows and reduce avoidable denials.
Article Sections
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Documentation problems identified in Medicare review
Introduces the compliance context for laboratory billing and summarizes the kinds of documentation issues identified in Medicare review activity. It also highlights why these problems matter for providers and practices.
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Bolster your referral process
Discusses broad steps for improving lab referral workflows and documentation practices. The section centers on how ordering and recordkeeping processes are evaluated in the context of lab billing.
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Shore up your signature policy
Focuses on signature-related documentation concerns and related record support discussed in the article. It also references compliance resources and guidance materials from Medicare-related organizations.
What You Will Learn
- How Medicare review activity can identify documentation-related lab billing issues
- Which referral-process documentation areas are emphasized in the article
- Why signatures and written support in the medical record are important to review
- What types of compliance resources are referenced for further guidance
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle teams
- Compliance professionals
- Referring physicians
- Practice administrators
Codes Discussed
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