PMID: 16519213Mar 8, 2006Paper

Teaming up for medical necessity compliance

Healthcare Financial Management : Journal of the Healthcare Financial Management Association
Linda Bosenbark, Anne Vincenti

Abstract

Healthcare finance professionals and other employees from departments involved with a hospital's revenue cycle can work together in many ways to minimize denials, delays, and write-offs: Verifying medical necessity when a patient is first seen, rather than when the patient arrives for service, so that an advance beneficiary notice can be issued and signed at the time of service. Ensuring that the proper codes and modifiers are assigned before a claim is submitted. Augmenting software compliance tools with human expertise in compliance and internal education programs to reduce errors over time before they reach the billing department.

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