 |
Bundling Denials Should Have Basis -
Requesting Clarification.
Bundling denials are highly problematic
because various payors use different claim editing software
to assess codes for compatibility. It becomes hard to
determine why certain codes were bundled and what medical
information might be persuasive in an appeal...Click
here to read the rest of this article.. |
|
|
New Appeals Book For Chiropractors:
Turning Chiropractic Denials Into Dollars
is the latest publication designed to assist chiropractors
with insurers’ delay and deny tactics. This book provides in
depth instructions on how to avoid and overturn denied
chiropractic claims. Information covered includes bundling,
medical necessity and policy exclusions/limitations issues
specific to chiropractic. A chapter is also devoted to
pursuing Level II appeals and forcing insurance carriers to
respond more fully to initial appeals. To assist
chiropractors with avoiding denials, Turning
Chiropractic Denials Into Dollars provides
instruction on seeking pretreatment disclosure of
chiropractic benefits and explains how to appeal if claims
are not paid according to disclosed benefits. Order today
by calling 888-399-4925. |
|
|
AppealLettersOnline.com New Letters:
AppealLettersOnline.com has
added two new letters to assist users with appealing
incorrectly bundled codes, including the following:
1) Request for compliance with Medicare CCI edits – This
letter is helpful in situations where it appears that the
Medicare CCI edits have not been followed. See
the AppealLettersOnline.com repository for a letter titled "Payment
Not in Compliance W/CCI Edits" under the Topic:
Benefit Reductions and the Subcategory: Miscellaneous.
2) Request for review of the coding by a certified coder –
This letter is helpful in situations where the claim was
likely processed according to claim processing software
instead of manually reviewed by a certified coder. This
would be an effective appeal on complex claims involving a
number of codes or unusual/infrequently used codes. See
the AppealLettersOnline.com repository for a letter titled "Request
For Review By Certified Coder" under the Topic:
Benefit Reductions and the Subcategory: Miscellaneous...Sign
up to access
these appeal letters at www.AppealLettersOnline.com |
|
|
Specialty Highlight:
CMS has a new web page
designed to clarify existing therapy policy and to provide
guidance on current Part B billing issues relevant to
physical therapists (PTs), occupational therapists (OTs) &
speech-language pathologists (SLPs) and the services they
provide. Visit
www.cms.hhs.gov/providers/therapy/billing.asp for
specialty-specific CCI edits, new codes and new coverage
determinations that impact therapy billing and/or to provide
clarification on billing policy for PTs, OTs and/or SLPs.
|
