Reimbursement for services is contingent on the information provided by the clinician including documentation in the patient's record and assigning the appropriate codes. Coding requirements by both the AMA and CMS are revised annually. Women's Health Connecticut has dedicated certified professional coders to support providers, their office staff and our Central Billing Office with the complexities of coding.
We provide:
- Current coding information and over 400 payor specific guidelines so that claims are completed accurately to avoid delays and denials.
- Support to code effectively, assuring appropriate reimbursement.
- Coding analysis of common coding problems and practical guidelines to solve them.
- Claims Preview for medical necessity diagnosis, appropriate use of modifiers, and identification of unbundled services.
- Specialty specific on-site coding and documentation training for clinicians/office staff with chart review to identify strengths and weaknesses in meeting documentation requirements.
- Appeals process for denied or inappropriately bundled claims to include clinical review and correspondence with supporting documentation.
- Review of all documentation requested by payors prior to submission to verify that documentation supports code(s) billed.
Our Results
- Accurate and clean claims submission with prompt payments, days in AR <40.
- Compliance with payor and government requirements for claims submission and documentation.
- Facilitated code selection by providers.
- Additional reimbursement for denied claims overturned on appeal.
For more information about our services and value to physicians, please click here.
