To prevent loss of money due to your practice, we need to determine the root cause of your denials.

Many factors can cause a denial, from information being entered incorrectly at the reception desk to prior authorizations not being obtained. It can be that the wrong ICD-10 code is being entered for that CPT code being billed or a missing modifier, or the insurance company needs medical records to substantiate Medical Necessity.

My company can help you put practices and training in place to reduce the need to reprocess or appeal many claims.

My experience stems from working as a Medical Assistant and Surgery Scheduler for over 20 years, and I understand the medical side of billing that your average Medical Biller does not. I also worked as an Eligibility and Benefits and Claims representative for a sizeable Nevada-based insurance company. They teach you what is needed to deny a claim, but it also works in reverse by providing the knowledge of what it takes to prove that the insurance industry should pay this claim.