According to a report under the False Claims Act, upcoding crimes results in some serious consequences, such as 5 years of imprisonment and fines worth up to $250,000. These hardcore penalties grab the attention of everyone related to the healthcare...
Understanding downcoding is essential to ensuring accurate and effective claim submission and timely reimbursement. Downcoding has significant implications for healthcare providers. According to medical billing industry reports, approximately 8%–10% of claims are affected by the downcoding. This percentage has increased...
One of the most challenging situations a healthcare facility can face is claim denial from insurance companies. Denials need to be addressed promptly for timely reimbursement. According to the American Medical Association’s (AMA) recent report on the National Health Insurer...
