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Health care providers are relying on medical billing companies to a greater degree in assisting them in processing claims in accordance with applicable statutes and regulations. Additionally, health care professionals are consulting with billing companies to provide timely and accurate advice with regard to reimbursement matters, as well as overall business decision-making. Compliance program guidance is a major effort by the OIG in its effort to engage the health care community in combating fraud and abuse. The development of these types of compliance program guidance is based on the belief that a health care provider can use internal controls to more efficiently monitor, adherence to applicable statutes, regulations, and program requirements.

In this article, we discussed the crucial role of denial management in medical billing and setting up an efficient denial management process to reduce claim denials.

Our Medical Billing and Coding Experts shared the basic guidelines for Place of Service (POS) Codes in this article.