The most common health plans and what you need to know about them

June 5, 2020

Main Points

You can solve denials and rejections by using a prescribed system

You can solve denials by reading the EOB, calling the insurance company, and taking action

You can solve rejections by doing eligibility checks, making sure demographic information is accurate,...

May 29, 2020

Main Points

Coordination of benefits continues to be a common denial reason and the solution lies with your patient

Missing referrals are a common denial reason and can be fixed with a little collaboration

Coverage terminated can be a frustrating denial but you have optio...

Main Points

A/R is inevitable but you can reduce A/R through collecting copayments, deductibles, and coinsurance amounts

A/R can be tricky but if you make sure that your claims are submitted according to your credentialing, then the claims should go through

A/R is managea...

Main Point

Fee schedules help you to manage your practice revenue

Fee schedules help you to ensure that insurance companies are paying you correctly

Fee schedules give you an idea of a fair market value for your services

Not knowing or having a copy of your fee schedules f...

Main Points

A fee schedule is a list of fees and services provided by an insurance company

Fee schedules are proprietary

Fee schedules are only given to in network providers

Let's say you go in for job interview. you are interested in working with this company and you are...

Main Points

Medical necessity is defined differently by different entities and it is important to know how it's defined

Medical necessity is defined by national coverage determinations and local coverage determinations

During the course of Private Practice you will receiv...

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