One of the more frustrating parts of practicing medicine is dealing with insurance company billing and coding requirements. We perform a service that is medically necessary, document the care provided, submit the claim, and sometimes receive a denial because we failed to meet an insurance company’s particular requirements.

The problem is that every insurance company has its own policies. A procedure covered by one company may not be covered by another. One insurance company may require a particular diagnosis code, while another may have additional medical necessity or documentation requirements. Even different plans offered by the same insurance company may have different coverage rules.

Much of this information is available on the insurance companies’ websites. The challenge is finding it.

AI can help physicians and their staff research these policies, identify the requirements that apply to a particular service, and locate the actual documents published by the insurance company.

This is one of the practical ways AI can help reduce the administrative burden of running a medical practice.

For the full article visit 

https://www.tldsystems.com/using-ai-research-insurance-company-billing-coding-and-coverage-policies