Know the Difference Between Appeal or Reprocess If a claim to an insurance carrier is denied, no payment will be sent to the provider. Providers are understandably frustrated with denials and may feel that it is not worth their time to appeal the decision. However, appealing a denied claim allows the provider to resolve an...
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Download Reference Documents Sometimes, when reviewing records to be sent, it’s clear that the note(s) were not properly signed and authenticated. In this instance, all is not lost. Even Medicare provides a way to offer Signature Authentication after the fact. If you have not already reviewed the module in this course regarding signatures, please do...
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Using a Case Summary Template When fulfilling a records request, regardless of the entity requesting the information, we recommend that you always include a Case Summary Letter. The template image shown on the right will help you tell the story of what occurred during treatment and illustrate the case management involved. It should serve as...
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A Records Request: A Common Occurrence So, you check the office mailbox – a few EOBs, checks from patients, a menu from the local pizza place, and (sigh) a love note from an insurance company requesting records for a patient. Before panic sets in, understand that this is a common occurrence in the chiropractic profession....
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When is a simple request for records not really a simple request for records? Almost every time. When a payer is asking for notes, whether for a current claim, or a retroactive review, it means something. It could be random, or it could be targeted and focused. Because you may not know, this is the...
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Download Support Tool What do you do when you feel or know you have documented your 9894X and 97140 CPT codes for the same visit correctly, you used the appropriate and correct diagnosis codes, appended the correct modifiers, all in accordance with the payer’s policy, but you get your services denied? The curbside appeal to...
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