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Q: A biller had contacted me saying that: “I can’t seem to get my first claim transmitted without some type of denial coming back. I am checking the CPT and ICD-10-CM codes and it all links together. What is going on?” A: The first thing is, there is an initial step that medical billers must take before they review the coding for a claim submission. Unfortunately, it’s the reality of the billing world where they have to focus on the competency of the practice’s front desk, and you need to monitor the denial trends because a lot of them point to the front desk. Billers don’t have time to appeal every denied claim, which can take anywhere from 5 minutes to over 2 hours. If you happen to work for a practice where the front desk is horrendous and they haven’t made any changes, then what I say is that every medical biller’s first step should be to review the registrations prior to reviewing the coding or anything else. That would be the first step in the process. Over 56% of claims denied due to the front desk. That is an average based on, I own a billing service which my family runs, but I look at the stats and stuff so that I can share it with my students, and some practices may have 30% denial rate and other practices have 70% all based on bogus information because the front desk is not doing their job. What you need to do as a biller is look: Is the front desk a qualified professional who is focused on the job? Medical billers, they require the front desk to understand the insurance, to verify the insurance and all the patient information before they’re seen by the doctor or healthcare provider. When the biller gets the information, the service has already been provided. So, if there is no insurance or any patient information is wrong, it’s very hard and it’s an extra step for the biller to take in order to get the claim paid. Even though working a front desk is not really difficult, if you do not work well in a chaotic environment, it’s not the place for you, so even if you are confident or your front desk person presents well, if they don’t work... you know, with folks coming in, patient is coming and going and people milling around and copayment is being collected, then you need to make some changes. The next slide, when I asked: Do the billers actually know what the insurance is about? This is an actual insurance card that I’ve taken from a billing company and just whited out important information. If you look at the bottom where it’s highlighted, it says United Healthcare Group Medicare Advantage (PPO). Medicare patient comes in, they have a Medicare card and they have this new Medicare Part C card, they hand it to the front desk. The front desk registers Medicare primary and this is secondary....