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Apr 7, 2020

The COVID-19 pandemic is putting unprecedented strain on the healthcare system. And while the challenges facing the front-line healthcare providers are most obvious and concerning, payers are not immune. They're facing hurdles driven by new codes, regulatory changes, and a surge in telehealth that challenges the ability to accurately process timely payments–a critical issue for providers.

On today’s episode, Dr. Frank Dubeck, chief medical officer for Payment Accuracy at Change Healthcare, joins Mike Boykin, value consultant; Tracy Mullen, manager of Clinical Development; and Kathleen Reid, product management leader for Clinical Claims Management to discuss claims code editing considerations during the global health emergency.

Here are the high points of their conversation:

  • New codes developed to deal with COVID-19
  • Editing to address the influx of telemedicine claims
  • Demystifying CMS and CPC telemedicine coding conflicts
  • COVID-19 diagnostic coding
  • Reviewing rules configuration in ClaimsXten to reduce denials
  • Frequency rules editing
  • How bundling rules are impacted

Episode Resources

  1. Amy Larsson's bio
  2. Dr. Frank Dubeck's bio
  3. Mike Boykin's bio
  4. Tracy Mullen's bio
  5. Kathleen Reid's bio
  6. Webinar: Claims Management and Payment Accuracy in a Pandemic
  7. ClaimsXten
  8. Coding Advisor Pre-Submission Claims Adjustment
  9. COVID-19 Updates & Resources
  10. COVID-19 Updates Newsletter

Show Resources