Understanding Medical Necessity Denials

[vc_row][vc_column][rev_slider_vc alias="med-necess"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]As a consultant my ultimate goal is to help everyone of my clients understand their revenue cycle and one of the most common snags I find are medical necessity denials. Medical Necessity Denials flow downhill as it is the responsibility of a Medical Professional to accurately document their encounters with a patient. From the Provider’s documentation, it is then the responsibility of the Coder(s) to abstract specific procedure and diagnosis codes...

Donna White
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Credentialing

Service Spotlight: Credentialing

[vc_row][vc_column][rev_slider_vc alias="credentialing72"][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]What exactly is physician credentialing? Essentially it is a payor's way of ensuring that the provider has met all necessary qualifications to practice and is providing the appropriate level of care to their patients. While not every payor requires a provider to be credentialed before they begin to see patients, many of the major payors do. This includes Medicare, Medicaid, Blue Cross Blue Shield in most states, United Healthcare, Tricare and...

Donna White
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