Martin Jacob

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PayerDataInsights
19 May 23

PayerDataInsights: A Series Exploring the Use of Data Analytics in the Health Insurance Payer Industry

Introduction In the ever-changing landscape of the healthcare industry, health insurance payers are constantly seeking innovative ways to improve their services, reduce costs, and enhance the overall experience for their members. Data analytics has emerged as a powerful tool that can help payers achieve these objectives by unlocking valuable insights…
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PayerIntelligence101
18 May 23

PayerIntelligence101: An Introductory Series Covering the Basics of Health Insurance Payer Intelligence

In today’s rapidly evolving healthcare landscape, health insurance payers are seeking innovative ways to improve their services, reduce costs, and enhance the overall experience for their members. One critical component of this quest for improvement is the growing field of payer intelligence. In this first installment of our PayerIntelligence101 series,…
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How-To-Use-Modifier-25-Correctly
28 Feb 23

How To Use Modifier 25 Correctly

Introduction The OIG has identified the following trends in modifier 25 errors: Modifier 25 should not be used on claims that have been denied by Medicare or have been adjusted to zero. Fewer than 20 percent of modifier 25 claims are correct. Overuse of modifier 25 has increased significantly since…
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MUE Facts That Will Help You Avoid Denials
02 Dec 22

MUE Facts That Will Help You Avoid Denials

Introduction Most healthcare providers are aware of the Medicare edits that can make it more difficult to get paid on claims. However, there’s a type of edit that’s not as well-known: MUEs, or Medicare Unique Edit Values. These codes indicate whether or not a particular service is UCR-related, meaning that…
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Overview
12 Nov 22

Internal Review – Overview

Introduction WWS’s internal review process helps us ensure high-quality coding and billing. We work with providers to ensure that their claims are as accurate as possible, which is why we recommend a 30-day Internal Review (IR) for all claims. The IR process uses the same methodologies used in an External…
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Overview
12 Nov 22

Essential Components Of The Medical Billing Workflow

Introduction As we speak of better and more efficient medical billing in healthcare, managing and moving patients through every visit while assembling data for the submission of claims and collecting the outstanding balances of patients, the components of the medical billing workflow work precisely its duty. Promote Patient Engagement ● …
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