3 Video Lessons
Incorrect Payments & Deductions
Insurance carriers now exercise great control over both in- and out-of-network payment through implementing fee schedules, usual, customary, and reasonable (UCR) limitations, and, more insidiously, computerized payment methodologies for applying internal bundling, downcoding, and other price control features. Often, it is difficult to even determine how a medical claim was paid and whether these payment policies are applied consistently and fairly across all similar claims. Read more about how to appeal incorrect benefit calculations.
Lesson 1: Incorrect Payment Appeals
When your organization appeals a incorrectly paid claim, is that appeal reviewed by man or machine? Unfortunately, most incorrect payment ap...
Lesson 2: Demanding Disclosure of Fee Schedule and/or Benefit Calculation
Medical organizations have a right to know how benefits were calculated. Read our appeal hints to effectively demand disclosure of critical ...
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President of Appeal Solutions, Tammy Tipton is an author and frequent speaker and expert on resolving denied and disputed medical insurance claims.
What You'll Learn:
- Incorrect Payment Appeals
- Demanding Disclosure of Fee Schedule and/or Benefit Calculation
- Appealing Claims With Modifiers
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