• Live Denials Q&A 10/15/24 - Tips for Denial Beginners

  • Oct 16 2024
  • Length: 54 mins
  • Podcast

Live Denials Q&A 10/15/24 - Tips for Denial Beginners

  • Summary

  • Mastering Medical Billing: Overcoming Claim Denials and Utilizing Key Resources

    In this comprehensive episode, we dive deep into various medical billing challenges and solutions. Key discussions include handling billing issues with UnitedHealthcare, specifically around lab claims and CLIA validation, and addressing billing problems with Medicare Advantage and other insurers like Cigna and Blue Cross. We offer practical advice on resubmissions, correct coding, and documentation to avoid denials. The importance of leveraging resources such as the AAPC website, MACs for webinars, and networking for educational support is emphasized. The episode features expert insights, such as those from healthcare attorney on combating downcoding and dealing with insurance companies. New and experienced billers alike can benefit from tips on maintaining contact lists, timely filings, and utilizing payer portals effectively.

    00:00 Introduction and Initial Query

    00:18 Clarifying the Issue with Modifier 90

    01:00 Understanding CLIA Requirements

    05:25 Dealing with UnitedHealthcare Denials

    07:12 Exploring Other Potential Issues

    09:33 Addressing Sentara Insurance Glitch

    12:00 Blue Cross Medical Advantage Claim Issues

    18:06 Cigna Appeal Process Challenges

    22:01 Medicare Advantage Plan Denials

    26:44 Medicare Billing Challenges

    27:17 Humorous Anecdotes and Introductions

    28:02 Addressing New Biller Concerns

    30:06 Sharing Tips and Resources

    31:33 Useful Websites and Tools

    34:08 Insurance Company Contacts

    35:02 AAPC Website Resources

    36:32 Medicare Denial Codes and Policies

    37:43 Importance of Bookmarking Resources

    39:20 Access to Payer Portals

    40:47 Training and Networking

    42:00 Medicare Billing Programs

    44:42 Final Thoughts and Suggestions

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