One of the many revenue cycle challenges are denials from insurance companies. Health information management professionals can assist in this process by ensuring all appropriate documentation has been made and submitted to support medical necessity for an insurance claim request. Proper documentation assures proper codes are assigned for diagnosis, tests, procedures, etc. It is imperative that each request made for coverage be ensured that it supports the patients diagnosis or suspected diagnosis. With the incorporation of these protocols there will be less time spend scheduling peer to peer reviews for denied claims.
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