Having handled claims for a wide range of out-of-network surgeons for over a decade, we have the unique advantage of knowing what triggers initial payment delays, underpayments or denials. Reviewing progress notes, operative reports and code selections, coupled with our understanding of CMS and payor-specific rules, enables us to helps our clients to avoid these triggers.
Recognizing that reimbursement strategies can vary depending on the payor, we work with our clients to implement a roadmap of best practices to avoid initial payment delays and to set up claims that will enhance our clients’ ability to maximize reimbursement.