Life as a Coder 15: The Who, What, Where, When, Why and How of LCD Policies

In todays episode we dive into LCD policies, Coverage and Evaluation and Management tips for Diagnosis Documentation. It is so important to understand the impact that Medical Necessity and Coverage guidelines play in reimbursement. Outside of direct care providers many patients rely on their insurance coverage to get the services they need. By accepting assignment on their behalf and submitting their claim we can aid them as professionals to continue getting these service and to be reimbursed the highest amount available. We can do this by understanding:

  • Current Active LCD Policies
  • Prior Authorization Criteria vs Coverage Guidelines
  • Documenting Risk and conditions that effect the risk
  • Timely Submission of accurate claims with supporting Documentation

Medicare Coverage Process

Patient LCD Disputes

LCD What’s New Report

LCD Q/A

Diagnostic Colonoscopy LCD

Do not keep writing off claims for preventable Prior Authorization Denials. Get started with Authparency

Watch it in Action!

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