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Felix Okhiria, MPA, MA, CCPO, CMPE, CPC, CHC

The best way to minimize denials is to prevent them in the first place, by making sure that medical claims meet the requirements for clean claims. A clean claim is defined as a claim that meets the standards required by insurance carriers for payment on first submission.

Medical billing is the process of translating a physician’s work into reimbursable language understood by governmental and private third-party payors. The billing process must start with the physician’s documentation of patient encounters, which forms the basis for billing. The physician’s documentation is then translated into a CPT® code