HealthcareFinance

M54 claim denials

M54 Claim Denials: A Guide to Prevention and Revenue Recovery

Leave a Comment / Denial Management, January 2025

M54 claim denials, indicating missing or incomplete total charges, are a significant drain on healthcare revenue. These denials often stem from seemingly minor oversights, but their cumulative impact can be substantial. Common Culprits Behind M54 Denials: Mitigating M54 Denials: A Proactive Approach Preventing M54 denials requires a multi-faceted approach: Partnering with Claims Med for Revenue […]

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Denial Code B10

Denial Code B10: A Major Threat to Your Practice’s Revenue

Leave a Comment / Denial Management

Denial Code B10 is a frequent stumbling block for healthcare providers, leading to significant financial losses. This denial signifies that the payer has already reimbursed for a portion of the billed service, often due to factors like: Mitigating the Impact of Denial Code B10: A Proactive Approach Preventing revenue loss due to Denial Code B10

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Out-of-Network Denials

Out-of-Network Denials: A Significant Threat to Practice Revenue

Leave a Comment / August 2024, Denial Management

Denials for services provided by out-of-network providers are a common challenge for healthcare practices. These denials occur when a patient receives care from a provider who is not part of their insurance plan’s network. This can lead to significant financial losses for the practice and increased out-of-pocket costs for patients. Understanding the Root Causes of

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CO 242 denial

CO 242 Denials: How to Prevent Out-of-Network Claim Rejections & Optimize Revenue

Leave a Comment / Denial Management, July 2024

CO 242 denials can be a frustrating financial setback for healthcare providers. This denial, indicating that services were provided by an out-of-network or unauthorized provider, often stems from insurance network issues, referral mismanagement, and coding errors. Without proper preventative measures, these denials can disrupt cash flow, delay reimbursements, and increase administrative burdens. What Causes a

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deprecated ICD-10 codes

Avoid Claim Denials: Stay Updated on Deprecated ICD-10 Codes

Leave a Comment / ICD-10, July 2024

Using deprecated or inactive ICD-10 codes in medical billing can lead to claim denials, delayed reimbursements, and administrative headaches. The Centers for Medicare and Medicaid Services (CMS) regularly updates the ICD-10 code set to reflect new medical practices, emerging health trends, and updated technologies. Failing to keep up with these changes can hurt your revenue

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bundled service denials

Unbundling Services: Avoid Claim Denials with the Right Modifiers

Leave a Comment / Denial Management, July 2024

Are claim denials for bundled services causing headaches for your practice? You’re not alone. Many healthcare providers lose revenue due to incorrect coding and missing modifiers, which can lead insurers to deny reimbursement for procedures they consider inherently included in another service. Understanding how to use modifiers correctly can make a significant difference in maximizing

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