Adjustments Equals Charges

Today’s BIG Ideas podcast is from a project I built a couple of weeks ago.  A practice in the Midwest wanted to track denials by finding procedure codes where the adjustments on the procedure equaled the charge amount.  With the exception of a few things like charges in a global period, adjustments equaling charges is almost always bad news.  Once you can find those adjustments, listen for ideas for how to trend and track denials.  Even if you can’t appeal the charges due to timely appeal requirements, you can still put workflows in place to reduce denials going forward.  Part of your objective needs to be to reduce denials so that your team will have enough bandwidth to appeal existing denials.  You will also hear some ideas about how to track successful denials and ways to prioritize working denials.  I hope you find these podcasts helpful.  Thanks for listening.