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p.28

Why are hospitals having more

   claim rejections and denials

Patient Financial Services has lost ability to completely “clean-up” claims on the back-end to positively affect reimbursement!

Appropriate “time” for control may be lost if all processes are not in place “prior” to provision of the service

Patient Financial Services (Business Office) does not:

register / schedule / admit

review for medical necessity prior to service

maintain the chargemaster

select / post charge

code the HCPCS / CPT-4 codes

code diagnoses / procedures

add modifiers

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