Managing Appeals Effectively and Efficiently

Navigating the choppy waters of the Appeals Process can be confusing and frustrating at best, but with a little research and insight, you can come out on top when challenging a denial. In the first tutorial, we address general claims, the reasons for denials, when an appeal might be appropriate, how to mount the appeal,...
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Personal Injury Follow Up – Attorneys

PI Follow Up  An important part of accounts receivable and its follow up process revolves around Personal Injury cases. When a patient receiving care for a PI has no insurance of his/her own and asks you to wait until the settlement is paid, s/he is asking you to “hold a lien.” Unfortunately, some states have...
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Paper Claims Billing

Not all payers accept electronic billing. Especially those Personal Injury or Worker’s Compensation payers. The process for billing is not different from electronic, other than all the “scrubbing” must be done by a human, not a machine.  Understanding the process of sending paper claims correctly and efficiently will be a boom to your cash flow....
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FAQs-Personal Injury Verification

Frequently Asked Questions- Personal Injury Q: What is a personal injury?  A: A serious, harmful act to a person or persons as a result of someone else’s negligence. Q: What does Personal Injury cover? A: Medical expenses, lost wages, accident-related injuries, and funeral expenses. Q: Do I collect money from the personal injury patient after...
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The Silent PPO Sting

Have You Been Stung by a Silent PPO? Have you ever submitted a claim to a personal injury carrier and then received a payment from a completely different party? Or you submitted a claim, and the payment comes at a discounted rate as if you were in network with a health plan? If you answer...
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Why Insurance Verification

Why Insurance Verification This quick tutorial explains why insurance verification is an important piece of the financial report of findings (FROF) with the patient. It contains the top tips to make the verification process simple and effective by reviewing the variety of tools available in the KMC University Library. This image provides a sampling of...
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