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One Doctor’s POV
Hi Ann,
Dr. Nicholas Fogelson wrote a perspective article for KevinMD.com. He wrote about his experience as a peer reviewer for an independent review organization network. The observations hit to the heart of why third-party peer review (for payers) and physician advisor services (for providers) are vital for building efficiencies.
The categories
Here are the main categories Dr. Fogelson saw while reviewing:
- Full-spectrum medicine
- Poor documentation
- Industry acceptance of something that cannot be supported in the literature or not evidence-based.
Assessment
The takeaway lessons, from Dr. Fogelson’s observations, point to two very fixable inefficiencies: better documentation and following evidence-based research for care.
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Click HERE for the follow-up blog on more reasons claims are denied.
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Conclusion
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Filed under: Accounting, Health Insurance, Practice Management | Tagged: BHM Healthcare Solutions, Dr. Nicholas Fogelson, Eric Duchinsky, Why Medical Claims are Denied? |
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