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Payer Audits

6 Tips for Successful Third-Party Payer Appeals

When even the slightest mistake on a claim form can lead to a denial or reduced reimbursement, you need to be on your toes. The good news is with some leg work third-party payer appeals can get you paid more of what you are due. While third-party payer appeals are a time-consuming complex process, they’re […]

Published Date: November 1, 2019

OIG Watch List: Protect Payments from Urine Drug Test Audits

The Office of Inspector General (OIG) added to its Workplan items that contractors will audit or evaluate with a more critical eye. If you bill for urine drug test or speech-language pathology services to Medicare beneficiaries, now’s the time to weigh your compliance risk and fix any issues. OIG Scrutinizes Urine Drug Test, Speech-Language Pathology […]

Published Date: October 31, 2019

Modifier 59: Anthem BCBS Rolls Out More Prepayment Audits – 25, 57, RT/LT Affected Too

Expect payment processing delays for claims with modifier 59, 25, 57, RT/LT from Anthem BlueCross BlueShield plans. The carrier has now implemented clinical prepayment reviews in 14 states. October 1 saw the program roll out in 10 new states including New York, Georgia, and Ohio. You may have several questions on why the insurer has […]

Published Date: October 19, 2019

Payer Audits

Payer Audits

6 Tips for Successful Third-Party Payer Appeals

OIG Watch List: Protect Payments from Urine Drug Test Audits

Modifier 59: Anthem BCBS Rolls Out More Prepayment Audits – 25, 57, RT/LT Affected Too

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