Live Denials Q&A 1/21/25

Navigating Denial Management and Best Practices in Medical Billing   In this episode, our host addresses common issues and questions related to claims denial in the healthcare industry. The session kicks off with a briefing about the recording process and the host's recent absence due to business commitments in Europe. The conversation delves into topics such as the upcoming conferences in Nashville, including the RCM Summit and Vive, and moderating panels on collaboration between providers and payers. The Q&A covers detailed discussions on claims denied for timely filing, challenges faced with behavioral health billing, the importance of accurate reason codes, and the complexities of dealing with authorization denials. Specific case studies are examined, including issues with Blue Cross of Massachusetts and UnitedHealthcare denials. The episode emphasizes the need for resilience, thorough research, and the use of technology in managing billing processes effectively.   00:00 Introduction and Housekeeping 02:34 Welcome and Updates 03:45 Upcoming Conferences 04:41 Panel Discussion Preparation 09:54 Q&A: Denial Management 15:28 Common Denial Issues 25:41 Behavioral Health Billing Challenges 31:06 Challenges with Authorization Denials 31:59 Manual vs. Technological Solutions 32:54 Dealing with Out-of-Network Denials 34:54 Frustrations and Resilience in Billing 35:50 Escalating Appeals and Insurance Company Tactics 38:22 Utilizing Support Networks 41:47 Specific Case Discussions and Policies 01:00:04 Conclusion and Final Thoughts