title: Optimizing revenue by reducing medical necessity claims denials.
abstract: A proactive approach will help avoid Medicare claims denials related to medical necessity requirements. Providers should familiarize themselves with applicable local medical review policies. A self-audit should target areas where the most money is lost to medical necessity denials. Educational tools and a letter that highlights the provider's approach to medical necessity can encourage physicians to comply with Medicare requirements when providing a diagnosis.
authors.affiliation: dcarter@provistas.com
authors.forename: Darren
authors.initials: D
authors.lastname: Carter
mesh_terms: D004502:Education, Medical, Continuing; D005377:Financial Management, Hospital / Q000592:standards*; D019983:Guideline Adherence; D018578:Hospital-Physician Relations; D006801:Humans; D007182:Income; D007318:Inservice Training; D007344:Insurance Claim Reporting / Q000592:standards*; D007349:Insurance, Health, Reimbursement; D008330:Management Audit; D016345:Medicare Part B / Q000592:standards*; D020380:Needs Assessment; D016134:Organizational Policy; D014481:United States