When a healthcare issuer submits a claim to a clearinghouse, the declaration goes through several levels before it reaches the coverage organization. First, the clearinghouse checks the claim for any missing or error facts. If a mistake is detected, the clearinghouse sends the claim lower back to the healthcare company with a notification of what desires to be corrected. Once all problems are resolved, the claim is then translated into the desired layout and submitted to the coverage payer for processing.
CPT Codes in Occupational Therapy A Guide to Accurate Billing and Coding
CPT codes (Current Procedural Terminology) are used to explain medical techniques and services. In occupational remedy, those codes represent numerous treatments, opinions, and re-opinions. One of the maxima generally used codes is the CPT code for occupational therapy evaluation, which includes 97165. This code is particular to a preliminary evaluation, helping therapists document their first interactions with patients. Accurate usage of those codes guarantees that the right remedy is billed, that’s important for reimbursement.
What is Fee-for-Service (FFS)?
As a Medicaid billing consultant with 12+ years of experience, I’ve seen firsthand how misunderstandings about fee-for-service (FFS) Medicaid lead to claim denials and lost revenue. As a Medicaid billing specialist who’s helped clinics recover over $1.2M in denied claims.
I’ll break down exactly how FFS Medicaid works, share state-specific tips, and reveal proven strategies to maximize reimbursements.
