Payer Follow-Up Part Two 1.0
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This course identifies common rejections and suggestions for follow-up.

 

After completing this course, you will understand:
* Identify examples of when follow-up occurs: unpaid balances, no activity, partial payment, and patient balances.
* Decide what activity to do when the payer states it did not receive the claim.
* List which payers are usually billed electronically.
* Analyze an account when a partial payment is received and determine follow-up steps, such as rebill the payer, bill the Patient, or adjust off the unpaid balance.
* Analyze the account and determine how to follow-up, including review of third party payer’s billing rules or regulations, question if the service provided is covered, assess the HCPCS/CPT and ICD-9-CM coding, evaluate the information on the UB, and communicate with various departments to resolve the issue.
* List reasons for a patient balance.
* List that denials and rejections may mean different things to various payers and select the differences between a contracted payer vs a non-contracted payer. and more…

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