Are your payers reimbursing what you expect them to, or are sneaky adjustment codes reducing your payments?
How long has it been since you reviewed adjustments on your claims?
Insurance payers use Claim Adjustment Reason Codes (CARC) and Remittance Advice Remark Codes (RARC) to explain adjustments to your practice’s billed charges. Mining CARC and RARC codes can help you understand why claims are being denied or reduced and help you make changes to reduce unjustified reductions. Listen to today’s podcast for ideas on what fields to include in a Pivot Table to analyze adjustments. You will also hear some ideas about how to combine adjustment codes into categories so you can assign responsibility and get accountability around adjustments. I hope these podcasts are helpful for you.