Missing Payment for Re-Evaluation Explained

Hot Topics from the KMC University HelpDesk | August 18, 2021

Many offices are plagued with payment issues for re-evaluations when performed during an active episode of care. Re-evaluations are necessary to prove the continued medical necessity of the care. Keep in mind that payers have enhanced claim edits for separate and distinct service modifiers such as -25 and -59. Every time they delay your payment, they are making more money. The key is knowing individual payer policies and learning how to fight the denials effectively.

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