Majority of Code Denials Can be Successfully Appealed
There are a number of changes and detailed nuances when coding for billing of certain orthopedic and spine surgeries. Ms. Ellis went through 15 common codes, and while they can be challenging, she said reimbursement denials can often be appealed.
"Only 35 percent of providers fight denials," she said. "You can be successful about 80 or 90 percent of the time, unless you have a provider who is actually trying to do something that is a compliance problem. Unless there is conflict, you have a high chance of getting your money back if you fight these denials."
More Articles on Coding and Billing:
3 Myths of Out-of-Network Reimbursements
Selecting a Medical Billing Partner: 3 Tips for Physician Practices
90% of Solo, Small Physician Practices Plan to Outsource Medical Billing
© Copyright ASC COMMUNICATIONS 2015. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.
To receive the latest hospital and health system business and legal news and analysis from Becker's Hospital Review, sign-up for the free Becker's Hospital Review E-weekly by clicking here.
- Capital One completes GE Capital healthcare finance service lending business acquisition: 5 key notes
- Bernie Sanders has outpatient surgery
- Hillside Endoscopy Center achieves accreditation: 5 key notes
- Alshemari Instruments launches a new surgical needle — 5 things to know about the Alshemari Needle Driver
- GI physician leader to know: Dr. Kalpesh Thakkar of Memorial Hermann Medical Group