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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