CAQH CORE: Want to Improve Your Claims Denial Management Process?

Sunday, January 31, 2016

Want to Improve Your Claims Denial Management Process?

Want to Improve Your Claims Denial 
Management Process?

Act Now - Survey Deadline is February 10, 2016.

Calling all providers, medical office managers, and claims adjustment reviewers faced with costly claim denials and adjustments.

If you are involved in the healthcare claim payment or remittance process and are facing costly manual claim denials and adjustments, submit a response NOW to the CAQH CORE Code Combinations Market-based Review Industry Survey.

How to Participate
 
Submissions for potential Market-based Adjustments can be made via an easy-to-use online form. Depending on your amount of input, the survey can take as little as one hour to complete.
The link to the submission form and a training webinar (advance to minute 19 for a live demonstration of the submission form) will point you in the right direction so you can be ready to submit before the deadline of February 10th.
 
Impact & Next Steps for the Market-based Review
 
Key benefits of the CORE Code Combinations include:
  • Reduced unnecessary manual provider follow-up
  • Decrease in faulty electronic secondary billing
  • Fewer inappropriate write-offs of billable charges
  • Improved billing of patients for co-pays and deductibles
  • Reduction in posting delays 
Submissions to the CAQH CORE Market-based Review Survey are reviewed by the CAQH CORE Code Combination Task Group to determine adjustments to the next update of the CORE Code Combinations. Your submission will lead to improvements that will save you time and money if you are struggling with inaccurate code combinations or if the code combinations are not meeting all your 
business needs.
 
Due to recent Federal mandates, practices and facilities nationwide have experienced noticeable improvement with their claims denial management thanks to clearer and more consistent use of the claim denial and adjustment codes. If for some reason you are not experiencing these benefits, contact CORE@caqh.org. 
 
Need more information? Visit the CORE Code Combinations website or contactCORE@caqh.org.


About CAQH CORE
CAQH CORE is a national multi-stakeholder initiative that streamlines electronic healthcare administrative data exchange and improves health plan-provider interoperability through an integrated model of operating rule development, adoption and maintenance. CAQH CORE has been designated by the Secretary of the Department of Health and Human Services (HHS) as the author for ACA-mandated operating rules. To learn more about CAQH CORE, visit www.caqh.org.

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