Tag: claim submission

outpatient Medicare claims

CMS Delays OPPS Claim Edits For Off-Campus Provider-Based Depts

OPPS claim edits slated to take effect this month will now start in October to give providers more take to adjust to billing changes for off-campus provider-based departments. CMS is postponing the implementation of outpatient prospective payment system (OPPS) claim edits that would require hospitals and health systems with multiple locations to list provider addresses […]
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Claims Management Automation Progresses, But Opportunities Remain

Providers and payers are increasingly adopting electronic claims management transactions, but remittance advice and prior authorizations are still largely manual. Electronic claims management adoption by plans and providers is at or above 80 percent for three of the seven transactions analyzed in the most recent CAQH Index. The CAQH 2018 Index showed adoption of fully electronic […]
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Fight Back Against Denied Insurance Claims: 5 Steps

Appealing a denied insurance claim can be frustrating, but don’t give up! By following these steps and understanding the process, you can increase your chances of getting the coverage you deserve. Here’s a detailed guide: 1. Understand Why Your Claim Was Denied (and Know Your Rights) Review the Denial Letter Carefully: This document should clearly […]
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