Straight talk on coding, billing & getting paid right.
Jennifer McNamara and Maya Turner have spent their careers inside practices, ASCs and payer fights. Every other week, they talk through what’s actually happening — and what to do about it.
The Payer Said No: When Should You Actually Fight the Denial?
From medical necessity and prior authorization to credentialing, patient responsibility, modifier 59, and payer policies, they discuss why understanding the reason behind a denial matters before taking action. They also touch on Independent Dispute Resolution and how to know when an appeal is worth the time..
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Just because a payer says something doesn’t make it true.Jennifer McNamara, from the blog post Top Payer Myths
Your hosts
Full bios
Jennifer McNamara
Jennifer McNamara is the founder and CEO of Healthcare Inspired LLC, where she focuses on transforming healthcare practices through expert billing and coding support. With a deep knowledge of compliance, Medicare regulations, and the revenue cycle, Jennifer empowers healthcare organizations to streamline their operations and ensure proper reimbursement.
Maya Turner
Maya Turner is the owner of Turner Expert Consulting, a firm specializing in providing high-level consulting services to healthcare practices. With a deep understanding of the healthcare landscape, Maya helps practices streamline operations, optimize their revenue cycles, and improve overall efficiency.
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Top Payer Myths: Fact vs. Fiction
If I had a dollar for every time I heard “the payer told me I had to…”—I’d have enough to cover the next denied claim myself. Let’s clear the air: Just because a payer says something doesn’t make it true. And just because something was denied doesn’t…
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