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AMA: 1 in 5 Medical Claims Incorrectly Processed

Greg Freeman, for HealthLeaders Media, February 2, 2011
  • Do you gather supporting documentation to respond to health insurers’ claims adjustments and routinely  submit appeal letters using easily accessible templates  to streamline and standardize appeals for common denials?
  • Does your practice maintain a follow-up log to monitor its communications with insurers regarding claims?
  • Does your practice hold internal claims processing and review meetings to periodically evaluate your work flow for ways to improve efficiency?
  • Do you persist in appealing your delayed, denied, or reduced payments until they are paid accurately?
  • Do you have a plan for complying with the 5010 and ICD-10 mandated updates? The deadline for upgrading electronic transactions to the HIPAA-mandated 5010 version is January 1, 2012, and the deadline for reporting ICD-10 codes is October 1, 2013.

The AMA offers an interactive library of resources and tools for improving claims submission and efficiency here. The tools are available free of charge.

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