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Medical Billing: How to Request a Hearing with an Administrative Law Judge (ALJ)

In medical billing, you may find yourself faced with a difficult Medicare situation and need an ALJ hearing. If you have tried a request for redetermination and a QIC reconsideration and are still unsatisfied [more…]

Medical Billing: How to Appeal to the Medicare Appeals Council (MAC)

As a medical billing professional, you may find yourself facing a stalemate in the Medicare Appeals Process. The Medicare Appeals Council (MAC) is part of the Departmental Appeals Board of the Department [more…]

How to Appeal a Workers’ Comp Medical Billing Claim

In medical billing, appealing a workers’ comp claim can sometimes be tricky. Often an out-of-network payer is responsible for paying a Workers’ Compensation claim. Many states have legislation in place [more…]

Medical Coding and Billing: Who (or What) is WHO?

As a medical biller/coder, the information you communicate from the provider to the payer is submitted to the information gathering organization known as the World Health Organization [more…]

Types of ICD Codes Used in Medical Billing

As a medical billing professional, you will need to become familiar with the ICD coding system. The international classification of diseases (most commonly known as ICD) classifies any disease or health [more…]

Differences between ICD-9 and ICD-10 Medical Billing and Coding Systems

As a medical billing professional, it is essential that you understand the differences between ICD-9 and ICD-10. Repeat after me: ICD-9 is to ICD-10 as VCR is to DVR. In other words, ICD-9 is the old school [more…]

Medical Billing and Coding: Get Prepared for the Move from ICD-9 to ICD-10

As a medical billing professional, you will need to know about the move from ICD-9 to ICD-10. The ninth edition of the ICD classification is ICD-9, which the U.S. has used since 1979. But ICD-10 IS [more…]

Medical Billing and Coding: How to Prepare for the 5010 Platform

With the move toward ICD-10 in medical billing, you will also be working with the 5010 platform. Some of the transition happens on the tech end of things, particularly with the transmission platforms your [more…]

Medical Billing: How to Troubleshoot Issues with the 5010 Platform

As a medical billing professional, the transition to ICD-10 means working with and sometimes troubleshooting the 5010 platform. Experts have already identified problems associated with the 5010 transition [more…]

Medical Billing: Causes of Claim Denial under the 5010 Platform

As a medical billing professional, you may find yourself faced with claim denial under the 5010 platform. Every step that delays the claim also delays the payment. Possible causes of rejections or denials [more…]

How to Facilitate the Transition to ICD-10 for Medical Billing in Your Office

The transition in medical billing to ICD-10 WILL happen and it is essential you understand how to facilitate this in your own office. As you move toward ICD-10, remember that claim transactions are the [more…]

How to Prep Office Staff to Transition to ICD-10 for Medical Billing

As a medical billing professional, you will need to prepare your staff for the transition to ICD-10 that is coming. After the back end is ready to roll for ICD-10 [more…]

Ten Practices of the Super Mediator

You’re not content with just being a mediator. You’re determined to excel in the field and become a super mediator. Here are ten tips that’ll take you from average to excellent. [more…]

How to Bracket the Way to Compromise

Bracketing is a technique for establishing a zone of potential agreement in mediation — an upper and lower limit between which the parties are willing to negotiate. Bracketing moves the parties closer [more…]

Ten Tips for Busting Impasse in Mediation

Ultimately, mediation is an exercise in breaking through impasse — a period during which the parties have lost hope that they can resolve the matter on that day and in that place. Impasse isn’t the end [more…]

Ten Major Mediating Mistakes and How to Avoid Them

In the heat of battle, keeping your cool and doing everything right is often very challenging. You’re going to make mistakes — everyone does. Hopefully, however, you can learn from other people’s mistakes [more…]

Successful Mediation Without Splitting the Baby

Splitting the baby is a common but usually ineffective strategy for mediating a dispute. As a successful mediator, don’t let the parties simply decide to split the difference. Instead, come up with a creative [more…]

Don’t Nibble at the Mediated Deal

Nibbling is a negotiation tactic that many mediation “experts” recommend as a means to get a bigger slice of the pie just as the deal is closing. Although nibbling can be an effective technique for one [more…]

Get the Mediated Agreement in Writing

Be sure to wrap up a mediation session that seems to be over so that the parties walk away with a durable, enforceable agreement . . . in writing.

In mediation, the parties often reach agreement very late [more…]

Make Sure the Mediated Deal is Durable

A mediation agreement is durable and enforceable when the parties are satisfied with the outcome. To ensure that the deal the parties reach is truly satisfactory to them: [more…]

How to Produce Mediation Paperwork

Although oral mediation agreements are enforceable, oral agreements in mediation can’t be enforced in a court of law against the will of one of the parties, because the rules governing confidentiality [more…]

How to Break Through Impasse in Mediation

Impasse occurs in mediation when neither party is willing to compromise any further on an issue. When parties reach impasse, they’re likely to regard it as the end of negotiations. They may tell themselves [more…]

Good Mediators Ask Why?

Why? is the first and perhaps most important question good mediators ask. It’s a question you can never ask too often, but it’s asked far too seldom.

A key rule for trial lawyers is to never ask [more…]

Problem Solving Questions in Mediation

As a mediator, you can never engage parties in the problem-solving process too early, but perhaps the best time is when the parties have effectively rejected every solution that’s been proposed. Ask this [more…]

How to Encourage Progress in Mediation

In mediation disputes where feelings of animosity and distrust run particularly high, the mediator should consider asking this question: What could [the other party] do that would be a sign of progress [more…]

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