decisionhealth Newsletters, Part B News - 2018 Issue 4 (April)
TCM claimants improve as utilization goes up, denials go down
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Article Overview
This article reviews Medicare claims data on transitional care management and tracks how utilization and denial rates changed over time. It is aimed at coders, billing staff, and practice leaders who want a high-level view of how TCM activity varies by specialty and place of service and why the topic remains relevant for reimbursement monitoring and compliance review.
Why This Topic Matters
Understanding broader TCM utilization and denial patterns can help practices assess whether their claim activity aligns with national trends and identify areas that may warrant closer operational review.
What You Will Learn
- How transitional care management claims changed over time in Medicare data
- Which specialties accounted for the largest share of TCM claims
- How denial rates varied across specialties and places of service
- Why utilization trends may be relevant to practice revenue monitoring
Who Should Read This
- Medical coders
- Billing staff
- Revenue cycle managers
- Practice administrators
- Physicians and clinical practice leaders
Codes Discussed
Code Ranges Discussed
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