MCRA professional coders provide live, real-time reimbursement coding support backed by objective coding conventions, while our coverage access professionals assist providers and patients in navigating the pre-authorization and denial appeals processes for commercial health plans.
Coding Hotline Services
Credentialed coders provide guidance relating to:
MCRA professional coders provide live, real-time reimbursement coding information and answer complex coding questions backed by objective coding resources and coding conventions.
- Diagnosis Coding
ICD-10-CM diagnosis Coding – For All Healthcare Providers
- Procedure Coding
CPT-4 Procedure Coding – For Physicians
- APC Assignments – For Hospital Outpatient & ASC Facilities
ICD-10-PCS Procedure Coding – For Hospital Inpatient Facilities
- Inpatient Facility Reporting
MS-DRG Coding – For Inpatient Facilities
- Technology Reimbursement Coding
HCPCS Level II Coding – For Facility Reporting of Products
Coverage Access Programs
Commercial health plans are increasingly denying coverage for new technologies and procedures. Even a small omission of clinical information can lead to an unwarranted denial.
MCRA’s Coverage Access team can assist providers and patients with the pre-authorization submission and denial appeals process for commercial health insurance plans.
Benefits Verification & Pre-Authorization Services
A coverage access team member will work with physician practices, facilities, patients, family members, and insurance companies to:
Perform insurance benefits verification
- Submit pre-authorization and denial appeal requests
- Manage the status of pre-authorization and denial appeal requests
- Provide consistent, comprehensive payor education regarding the procedure
MCRA's coverage access management team assists providers and patients by:
- Verifying patient benefits and identifying coverage environments for provider indicated treatment options
- Providing a repository of published clinical data describing the procedure and clinical study outcomes
- Understanding and communicating the information that health plan reviewers are requesting for case review
- Educating the provider and patient about prior authorization appeal rights and processes
- Preserving prior authorization appeal options by monitoring individual health plan deadlines and requirements
- Supporting case access with distribution of applicable resources and patient advocacy
Our Integrated Approach
Correct reimbursement coding is critical to accurately describe patient diagnoses, services performed, and items used in patient treatment. Establishing a coding and reimbursement hotline provides a central place for providers and patients to access up-to-date information related to your company’s technologies, procedures, and available reimbursement coding options.
MCRA offers a full service coding and reimbursement Call Center to assist device manufacturer representatives and their clients with up-to-date coding and reimbursement information for FDA approved or cleared products and their related procedures. A dedicated team of certified professional coders provide live, real-time reimbursement coding information and answer complex coding questions backed by objective coding resources and coding conventions.