5 steps in Adjudication - the info insurance companies are looking for in claims in medical billing 1) 1:15 Claim is NOT Duplicate 2) 1:37 All necessary details are present 3) 2:44 Participation, Expectations, Rules 4) 3:43 Determine if benefits ALLOW for the service 5) 4:20 Final Determination (Payment or Denial)

@InleraU

11 ай бұрын

Thank you!

Thank you so much for posting this! Super helpful and easy to digest. And I agree, you are a great presenter. Look forward to learning more!

@InleraU

2 жыл бұрын

Yay :-)) Thanks so much! I truly apprecite your feedback and so happy you have found it helpful!

This was one EXCELLENT video. You're quite the presenter! I learned so much in the 6-ish minutes it took to watch. Thank you!!!

@InleraU

2 жыл бұрын

Wow, thanks! I so appreciate the phenomenal feedback!

Thank you for taking your time explaining this process.

@InleraU

2 жыл бұрын

You are so very welcome :-) Glad it was helpful! Feel free to let me know of any additional topics you would like covered in a future video.

Thank you.

@InleraU

3 жыл бұрын

You are so very welcome! Thank you for being apart of our community!!

Wow Great Job 👍👏

@InleraU

2 жыл бұрын

Thank you! Cheers!

Thank you for creating these videos. I have been a biller for many years and it serves me to better communicate with management. On interviews the billing terminology is a must. Also, you are a great presenter. Look forward to learning more! 4 Reply

@InleraU

Жыл бұрын

You're welcome! Thank you for watching and enjoying them! Let us know if you have any specific topics you'd like us to cover 😄

Thanks!

@InleraU

2 жыл бұрын

You are so very welcome! Thanks for the love :))

Thank you fr this knowledge

@InleraU

2 жыл бұрын

You are so very welcome! Thank you for your comment!

you teaching way is so amazing 👍🏻

@InleraU

6 ай бұрын

Oh so kind of you. Thank you 🙏🏽

Good one

@InleraU

7 ай бұрын

Thank you!

Great vide again on these 5 steps of adjudication. Would you also post a video concerning EOB's? Especially as they relate to the UB and 1500

@InleraU

2 жыл бұрын

Thank you for watching. I will add this topic "video concerning EOB's related to the UB and 1500" to our video's list.

Thank you

@InleraU

2 жыл бұрын

You are very welcome!! 🙌🏾

plz give a practical training using the practice management software like insync

Great video, it was great how you broke the process down in common terminology. You may have already posted on "BALANCING UB's and 1500's"... If you have, please provide that link. If you haven't, would you please consider doing so? I am ever learning my career and I am attempting to excel more and more as it evolves. Thanks

@InleraU

2 жыл бұрын

Thank you so much for your comments.

Thanks for giving knowledge on us Healthcare ajudication. I need more about. Please make a new video, How to. Process the claim, & which application are use.

@InleraU

2 жыл бұрын

Hi Jammejoy, Will do! Thank you, I will add these topics to my discussion list. Please let me know if you have any more questions or concerns.

We welcome you Mam

@InleraU

Жыл бұрын

Thank you for the kind words!

Please upload some videos about Denials & their explanations.

@InleraU

2 жыл бұрын

Thanks Sunmeet! I will absolutely work on recording a few of the top denials and get them up as soon as possible

Great infos, thanks for this video. Can you kindly make a video regarding comparison between (Claims Adjudication, ITS Adjustment and IQT) too..

@InleraU

2 жыл бұрын

You are so very welcome! :) Thank you for the compliment of watching them. I have added this topic to our list of videos to release soon. Thanks!

@aftabzamanvlogs1390

2 жыл бұрын

@@InleraU My pleasure, eagerly waiting for the mentioned topic videos 😊👍🏻

TY would love some information on doing transportation claims if this is possible. ty

@InleraU

2 жыл бұрын

I will see if I can get someone on for that specialty.

Can we consider, accepeted for adjudication as Claim is in Process?

there’s something i did not get. You mentioned in a previous video that Denial happened after Adjucation and Rejection when the clearinghouse rejects the claim, but you mentioned here that last step of adjudication is approve or denial. Do you think you can tell me where I am wrong?

Hi , do you have videos on how to properly fix denial codes? by the way all videos are very useful to me.

@InleraU

9 ай бұрын

Yay!! :-)) So happy to hear you gaining value from the videos. I do not have any denial codes resolution videos up yet but its in the plans. Until then I would suggess joining the Medical Billers Network Facebook group and the ZOom Meetups as they cover denial resolution quite often.

I am a Pharmacy Tech and it baffles the mind how many patients dont bother asking if a new RX needs a prior authorization from the prescriber. It slows down dispensing to a crawl for many 🙄🙄🙄🙄

@InleraU

11 ай бұрын

It can be frustrating, but it is important to remember that patients might not have the knowledge that some of us do. That's why we want to educate people not in medical careers, because everyone can benefit!

Great video thank you. I herniated 4 disc on my 4th day at new company (old boss) and they based my compensation off a coworkers pay but coworker doesnt get o/t were as i get 10-20 o/t hours a week. I recieved an adjudication letter from md workrrs comp saying the rate & would be backdated however no one else seems to know about this letter. Kinda confusing. Lol

@InleraU

6 ай бұрын

Thank you for your common! Yes, it’s just really a fancy way of them, saying that they are reviewing your claim against their policies and regulations.

Could you explain different between claim adjudication and denial management?

@InleraU

2 жыл бұрын

Yes!! Recording this video this week :))

Thanks

@InleraU

2 жыл бұрын

You are so very welcome 🤗

What is 820 EDI transaction set ? And how do we track denials in this transaction set Thanks for your support 🙏

@InleraU

9 ай бұрын

Thank you for you comment! Is 820 EDI a US healthcare ANSI EDI Transaction? I'm not sure how this information is relevant for the healthcare business management or revenue cycle management.

Commercial claims under contract and non-contract provider TFL how many days.

@InleraU

Жыл бұрын

Sorry that is dependent upon the insurance carrier. You can Google to obtain most of that information.

it keeps telling me to go change ssi number which is wrong, i am unable to go in and change it

@InleraU

2 жыл бұрын

What insurance carrier?

She left out the side for the patient participation or agreement.

@InleraU

9 ай бұрын

We will put that on our list for the next time we cover adjudication. Thank you for the suggestion!!

Beautiful Wifey 💓👑! How are you Queen?

@InleraU

2 жыл бұрын

Great :)