Live Denials Q&A 9/5/24 - Hospice, SNF, Home Health denials + takebacks

For The Love of Revenue Cycle

In this episode, Vanessa Moldovan, CEO and Founder of 'For the Love of Revenue Cycle,' leads a live Q&A session on handling denials in medical billing. Participants from different sectors of the healthcare revenue cycle, including medical billing for home visits, nursing homes, and surgery centers, discuss challenges they face with denial codes, modifiers, and reimbursement issues. Key topics include understanding the new FY 2024 hospice final rule, addressing denials related to modifier codes, and strategies for handling electronic remittance advice (ERA) take-backs. Suggestions for actionable steps and resources, such as consulting specific websites and joining relevant forums, are also shared.

00:00 Introduction and Purpose of the Q&A Session

00:49 Challenges in Revenue Cycle and Denials

02:07 Participant Introductions and Their Goals

03:11 Open Forum for Questions and Discussions

04:14 Lauren's Denial Issue with Chronic Care Management

09:26 Exploring Possible Solutions and Resources

21:08 Roseanne's Issue with Take Backs on ERAs

28:22 Provider Targeting by Payers

28:38 Options for Receiving Take Backs

29:03 Challenges with Electronic ERAs

29:44 Appeal Deadlines and Paper Forms

30:11 Denials Due to Grouper Edits

30:53 Hospital Denials and Resources

33:13 Questions on Prolonged Services Billing

37:08 Issues with Nursing Home Billing

45:29 Seeking Expert Advice and Final Thoughts