Payer Follow-Up Part Two 2019
This course identifies common rejections and suggestions for follow-up.
- Identify examples of when follow-up occurs: unpaid balances, no activity, partial payment, and patient balances.
- Decide what activity to do when the payer states it did not receive the claim
- List which payers are usually billed electronically.
- Analyze an account when a partial payment is received and determine follow-up steps, such as rebill the payer, bill the Patient, or adjust off the unpaid balance.
- Analyze the account and determine how to follow-up, including review of third party payers billing rules or regulations, question if the service provided is covered, assess the HCPCS/CPT and ICD-9-CM coding, evaluate the information on the UB, and communicate with various departments to resolve the issue.
- List reasons for a patient balance.
- List that denials and rejections may mean different things to various payers and select the differences between a contracted payer vs a non-contracted payer.