It is essential that healthcare providers receive the correct payment for the services performed and documented. Therefore, it is vital that providers are well-informed and kept up-to-date with the constant changing of specific coding rules and individual insurance policy guidelines to obtain the highest reimbursement allowed.
Medliminal will provide training and assessment on the following areas: Evaluation and Management services, the practice’s top utilized coding situations, current fee schedule analysis, reimbursement issues, fraud and abuse issues pertinent to your practice and a review of documentation to ensure accurate claim submission. Our training will improve your documentation, coding and initial claim submission to decrease your aging account.
Medliminal will provide a comprehensive report to identify risk areas, compliance issues and suggestions to improve your billing and documentation practices. It is essential that providers document, code and bill their services correctly to ensure compliance with government and other insurance carrier guidelines.
Medliminal’s chart reviews identify problem areas such as incorrect billing of modifiers, inappropriate evaluation and management level of service, National Correct Coding Initiative bundling issues, poor documentation that does not support medical necessity of the service and other risk areas.
Medliminal uses the Employee Retirement Income Security Act of 1974 (ERISA), the Department of Labor, State Statutes and the Patient Protection and Affordable Care Act (PPACA) to ensure proper and maximum reimbursement for your claims.
*We will perform an analysis of current and past 18 months of denied and/or underpaid claims, confirmation of eligibility and benefit verification, analysis of the Explanation of Benefits (EOB) for accurate reimbursement and a response to appeals with supporting documentation and sources.