Studies show that practices are routinely underpaid on their fee for service claims in government and commercial claims. In our fast paced payment posting world, where hundreds and thousands of line items are posted from a single electronic remittance file, a human is often not even able to see what would otherwise be obvious. So, how can anyone be certain that their claims have been adjudicated correctly and that the practice hasn’t been short changed? Even if you look at your data regularly, knowing whether you are getting paid for the services you bill out if difficult because no two payers process claims exactly alike. Each payer uses proprietary rules from ranking of RVUs, to which CPT code is in what order on the claim form and then modifies the payment based on the place of service, whether a provider is a doctor or an advanced practitioner, bundling and their own rules about paying codes with modifiers. This session will include a very high level review of the many issues that can cause underpayments to happen, the options available within Centricity Practice Manager and how one practice finally found a way to use their payment data in Centricity to find underpayments with enormous financial success
Click the link below to view the 2018 Centricity™ LIVE presentation.