The article focuses on the top five reasons for Medicare claim denials in the U.S. It highlights the factors that serve as the main reason why Medicare claims are denied by the Centers for Medicare and Medicaid (CMS) in the country. It also provides tips for health facilities on how to...
The CMS (Centers for Medicare and Medicaid Services) introduced Meaningful Use only to compel healthcare professionals to adopt to EHR and go digital. Despite78 percent of physicianshaving a certified EHR, there’s so much they can do, considering their specialty. Not all EHR software is built ...
When compared to the newly proposed Medicare for All Act-2021 (HR 1976) , Biden’s plan is disappointing and at best a band-aid approach. We need a system that is truly universal—everybody in, nobody out. Biden’s proposal will add more participants to the current program, but still ...
Denial Rate It goes without saying that all of this data tracking requires a lot of time and organization. And as I mentioned above, once you have the data, you have to know how to use it to make intelligent business decisions that’ll support your practice’s financial health. So, if ...
There are also promises that are in many ways like debt, but that technically aren’t guaranteed, because legislatures can change the promised benefits whenever they choose. Examples of these are our current Social Security program and Medicare benefits. Citizens depend on these programs, even if...
The article discusses the report from Highmark Medicare Services which indicated that denials are ensued by lack of documentations to support the need for patient hospitalization. It notes that the reviews were conducted to ensure that billing for services to Medicare were covered, accurately coded,...
For each item of each case, the presence of a specific factor being cited as a reason for denial was determined if at least 6 of the 8 independent reviewers identified it as so. Similarly, concurrence or disagreement with the judgment of the Medicare Contractor was determined. Results Of the...