ETHOS AND PROGRAM DESIGN The central premise of the Carenodes Behavioral Health Case Management (BHCM) Program is to promote collaboration between all treating providers, ensuring
Category: Providers
Before challenging a claim, examine the reason for your denial. The reason for the payer’s denial can be found on the Explanation of Benefits or EOB. In some cases, the denial may have been caused by a clerical error such as an incorrect CPT code, a missing signature, or another simple oversight.
Carenodes contracts with physicians, facilities and other health care professionals to form our provider networks, which are essential for delivering quality, accessible and cost-effective health care services. In partnership with providers (medical and non-medical, behavioral, primary, substance abuse, and others), we have developed (and are growing) community-wide coalition efforts geared towards addressing larger systemic health, infrastructure or social determinant issues with a large impact on health.
E&M Coding Advice
Physicians and Medicare alike have struggled for many years with correct coding, documentation, and payment of evaluation and management (E&M) services. That’s because, by their nature, E&M services are a diverse set of cognitive procedu
If you have not updated your practice’s fee schedule for several years, you may be in for some surprises. Carenodes Advisory recommends that you analyze and update your fees annually to make sure they are higher than insurance allowables.
Sample Letter (SB 418): Paper Claim in Process over 45 days
Dear Payer: Please be advised that this letter is to request final resolution of the claim/services in question. … We are aware that the Texas Prompt Payment law (28 TAC §§21.2801 – 21.2824) p
Carenodes network secures funding from Health Net Health Net has grant funded a proposal by Insight Choices, in partnership with Carenodes, to expand virtual healthcare delivery capacity and
Health Net has grant funded a proposal by Insight Choices, in partnership with Carenodes, to expand virtual healthcare delivery capacity and accessibility. In response to
I had the distinct opportunity to serve as a judge for CSULB’s College Bowl 2020, side-by-side with top industry leaders from Kaiser, AltaMed, medical informatics
As a longtime healthcare administrator, from managing 28 safety net clinics across CA and TX, to 14 hospitals, over 50 skilled nursing facilities, and 1