Articles Tagged With: claims
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Basic Coding Knowledge Allows Patient Access to Stop Denials
Inaccurate coding causes compliance issues, more denials, lost revenue, and negative patient experiences. More precise and accurate information from the onset sets the stage for correct billing, cleaner claims, and fewer denials.
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Health Plans Turn to Third Parties to Handle Claims and Authorizations
Health plans are increasingly working with third-party business partners to manage certain operational activities. Although third parties may help save money, for patient access, it could mean more claims denials and authorization hassles.
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Assessing Malpractice Coverage for Improvements
Medical malpractice insurance is a vital part of any risk management program, but it is easy to assume that whatever coverage you have had for a while is adequate. It may not be, and a regular review of your insurance policies is a good way to avoid nasty surprises.
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Some Attorneys Vow Not to Sue Over COVID-19 Care
Risk managers are bracing for what some fear will be a wave of malpractice claims related to COVID-19 care. However, some attorneys say they will not take these cases, arguing the treatment standard is unclear, and substandard care claims cannot be substantiated.
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Malpractice Claims Information a Powerful Patient Safety Tool for ED
At the UMass Memorial Medical Center ED in Worcester, analyzing medical malpractice data has become a vital patient safety tool. Leaders study adverse event data, root cause analysis, reportable events, and malpractice claims data.
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Pooled Malpractice Data Show True Prevalence of ED Claims
A decade’s worth of malpractice claims data allowed three Phoenix-based ED groups to improve care of spinal epidural abscess patients.
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Missing Clinical Documentation Reason for Many Claims Denials
More health plans are asking for certain pieces of clinical documentation before paying claims. If it is not there, the claim is denied. What are the specific issues arising?
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Ethical Issues for Individuals Providing Unproven Stem Cell Treatments
There are well-established, significant ethical concerns regarding the safety and efficacy of treatments offered by stem cell clinics. Much less is known about those actually providing these unproven interventions. Now, researchers have collected data about their background and training.
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Prior Authorizations: ‘Top Issue Within the Revenue Cycle’
A growing number of states have passed prior authorization legislation to combat payer requirements resulting in delayed care, lost revenue, and dissatisfied patients.
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Internists Sued More Often for Injuries
Internists more likely to be sued for high-severity injuries than doctors in other specialties, according a study of 1,180 claims against internal medicine physicians insured by The Doctors Company, the nation’s largest physician-owned medical malpractice insurer, based in Napa, CA.