United Healthcare Appeals
Starting February 1st all appeals must be submitted electronically for United Healthcare UHC claims. From reconsiderations to appeals, the electronic only submission requirement will impact providers nationwide.
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This course explains the significant role chiropractic care can play in the sports industry and how a DC can succeed as a Sports Chiropractor. Start your steps to success here!
Sometimes you need more than a self-service, on-demand program and need an expert to analyze your issues, train the corrections, and help you implement the changes, so they stick
The most effective chiropractic OIG compliance programs are scaled according to the size of the practice!
Starting February 1st all appeals must be submitted electronically for United Healthcare UHC claims. From reconsiderations to appeals, the electronic only submission requirement will impact providers nationwide.
Hot Topics from the KMC University HelpDesk Our HelpDesk has received an increase in calls about when an office can charge a patient for a…
Some practices deprioritize appealing claims as ‘grunt work,’ but nothing could be further from the truth when it comes to appeals.
Without checks and balances in place, a practice is at risk for mistakes, missing money, and out of balance accounts. Here are several procedures you can put into effect to protect your office:
A CAs job is never done. Offices need to have systems and procedures in place that will manage both outbound claims, inbound checks, and accounts receivable.
One of the more common questions we get at our Help Desk is what to do with Explanations of Benefits (EOBs) for paid claims once the payment has been posted. Regardless of the payer class, whether personal injury, worker’s compensation, or simple commercial insurance, you have many choices and can select one that is best for your practice.
More and more, third-party payers have written medical review policy deeming roller table type traction as experimental, investigational, and unproven. However, because it is usually billed as 97012, Traction, the payer wouldn’t know that the service performed was roller table and would likely pay it. It’s up to the provider to be aware of these kinds of rules. Billing with a deceiving code could be dangerous.
When it comes to reimbursement, most chiropractors and team members believe they are not being paid every dime they deserve. Third-party reimbursements have indeed been shrinking while documentation requirements have increased. As a result, it has become practically impossible to thrive in an insurance only practice.
Should you verify the patient’s insurance before the first visit? On the first visit? Before the Report of Findings (ROF)? Do you perform a Financial Report of Findings (FROF) first? Or do you submit the claim and wait for the Explanation of Benefits (EOB) to come. All of this uncertainty could be solved with a simple insurance verification.
Electronic claims processing is still the fastest, most efficient way to file insurance claims, where possible. However, there are times when a paper billing process still applies for your practice.