The Importance of Checks and Balances

Ways to Minimize Reimbursement Denials from Insurance Companies

The process of managing reimbursement is complex, but practices that hire an adequate number of billing staff, train staff effectively, provide conscientious billing practices, file in a timely manner, and have a closed-loop system in place for reviewing denials and implementing fixes are poised to ensure that claims are accurate, and denials are minimized.

In the article, Top 9 Reasons Why Insurance Companies are Denying Reimbursements, Anne A. Stefurak, Global Director of Health Economics and Reimbursement at Avanos provides insight into various reasons insurance companies are denying reimbursements, and ways which may avoid these issues including:

  • Ensuring proper training and communication for clinical support staff
  • Creating a claims review task force
  • Staying up-to-date on CPT code (Current Procedural Terminology) changes
  • Establishing documentation guidelines and multi-factorial practices

Anne A. Stefurak RN, CPC, COC

Anne Stefurak has 17 years experience in medical device and biotech reimbursement. She is a registered nurse with certifications in professional and hospital outpatient coding (CPC, COC). Her reimbursement experience extends to implantable devices, minimally invasive devices, capital equipment and biologics. She also has significant experience in managed care contracting, prior authorization and appeal processes as well as practice and hospital administration.

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