Valuable Insights Healthcare Providers Need to Know in 2017

Posted by Advent Health Partners on Jul 25, 2017 4:50:05 PM

There’s a massive amount of content out there for healthcare providers to gain insight into pertinent topics. To ease the headache of searching, we have compiled a list of resources that providers have found most valuable and relevant in 2017.

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Understanding the Difference Between MDM and Medical Necessity

Posted by Advent Health Partners on Jul 18, 2017 2:42:31 PM

The claims process is complex, requiring accurate supporting documentation and multiple codes.  To ensure they receive payment, providers must be certain to furnish payers with adequate data to justify why they opted for a particular test, procedure, or follow-up visit.  While some clinicians include copious notes in the patient record, the emphasis should be on quality rather than quantity when documenting MDM and medical necessity.

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How to Stop Medicare Claim Denials Due to Medical Necessity

Posted by Advent Health Partners on May 5, 2017 11:25:32 AM

With the shift towards value-based care coupled with the ICD-10 coding requirements, Medicare claim denials for medical necessity will most likely continue to plague your healthcare revenue cycle. Because medical necessity denials usually stem from inadequate documentation on the claims, the first line of attack to conquer the problem must come from physician documentation. ICD-10 calls for greater specificity than ever before. What may have passed under ICD-9 as proper coding for medical necessity may be insufficient today.

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How to Evaluate Medical Necessity With More Accuracy

Posted by Advent Health Partners on Mar 16, 2017 8:50:00 AM

Medical necessity continues to be one of the most common reasons that claims are denied by Medicare and other payers. While your organization may also note other areas where processing claims should be improved, it's likely that medical necessity falls into that category. The good news is that most denials can be prevented with proper documentation and an organized, efficient protocol to evaluate medical necessity in patients.

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