How SSI Simplifies Revenue Cycle Management

Now that you’ve read about the top five types of claims denials and the top two KPIs to keep a watchful eye on, SSI experts Lori Brocato and Kaylee House share key strategies to help you and your organization make improvements in denials management.

SSI claim denials management series part 2 of 3: What are the top five most common types of claim denials?

Eligibility related denials often result in a hard denial or one where you will not likely be paid and these include those related to coordination of benefits, plan coverage, incorrect plan code entry, maximum benefit exceeded, inactive coverage, or even member not found. These types of denials often stem from either the information not being obtained from the patient during preregistration or when they present at registration.

DDE v. EDI – Does Claims Submission Method Really Matter?

The ability to use Direct Data Entry (DDE) into Medicare Fiscal Intermediary Shared System (FISS) has been around for decades and is still widely used today. Even with the proliferation of Electronic Data Interchange (EDI) transactions that can be used instead, users still use DDE to manually enter, correct, adjust, or cancel Medicare transactions in FISS.