Wound Care Articles and Insights
February 20, 2024

FAQ: Denial & Audit Support by WCA

Christina Le

Q: How does WCA support wound centers dealing with Denials?

A: When it comes to Denial Prevention and Support, our team dives right in. We stand shoulder-to-shoulder with you, guiding you through the process. We know that sometimes billing for wound care can be arduous and complex. That's where our expertise comes in. Our Documentation and Coding experts meticulously comb through everything, especially when procedures like debridement, HBO, or CTP are involved. They don't just point out the problem areas; they offer actionable recommendations to ensure that diagnosis and procedure codes are on point.

Sometimes, a denial is warranted. When that's the case, we’re honest and help to navigate next steps and educate to prevent a repeat performance in the future. That's the Wound Care Advantage way – honest, expert, and always in your corner.

Q: Explain the HBO and CTP hotline? What is it? Why is it beneficial to our clients?  

A: The HBO and CTP hotline is a tool designed to provide clients with feedback on their documentation before utilizing CTP or HBO treatment for Medicare patients. We meticulously examine every aspect of the documentation. Our goal? To ensure accuracy and completeness according to Medicare NCD, LCD's, and LCA's. The bottom line? We leave no room for error, minimizing the chances of a negative audit outcome or denial of services. 

Q: What if you get audited?  

A: We recently had a client undergo a TPE Audit. Throughout the process we provided unwavering support. From navigating discussions with CMS to offering specialized documentation training. What sets this client apart is their proactive use of our HBO Hotline. Their meticulous documentation, facilitated by our hotline, ensured a seamless submission process for HBO charges. As a result, they passed the TPE Audit with flying colors on their initial attempt. Now, they’re armed with confidence and clarity and able to reclaim every penny rightfully earned, thanks to our comprehensive support and expertise. At WCA, we don't just navigate challenges – we empower our clients with powerful solutions.

Q: Why would a wound center need Audit and Denial Support?

A: The necessity for denial support in wound care centers boils down to a few key factors.

First, wound care denials might seem insignificant compared to other hospital denials, but those small dollars can accumulate rapidly. Often, the wound care department may not even realize they've been denied until it's flagged by the billing department.

Understanding these denials is crucial. It's not just about recouping lost revenue; it's about identifying areas for improvement in documentation and processes. By grasping why these denials occur, we can effectively enhance our practices and educate the center to excel in the future. It's all about continuous learning and refinement, ensuring we're always at the top of our game.

Q: How does Denial Support impact the hospital? What’s the bottom line? 

A: Denial Support plays a crucial role in positively impacting hospitals, especially when it comes to wound care. Many hospitals have limited expertise when it comes to wound care. It's a specialized field that requires a deep understanding of not only medical procedures but also the intricate documentation requirements demanded by payers like Medicare.

Our Denial Support service fills that knowledge gap. We have experts who eat, sleep, and breathe wound care. They know the ins and outs of the process, from initial documentation to fighting denials tooth and nail. By providing this specialized support, we're empowering hospitals to navigate the complex world of wound care with confidence. Centers equipped with this service not only see a reduction in denied claims but also experience smoother workflows and increased revenue capture, impacting the hospital’s bottom line. 

About Wound Care Advantage

For over 20 years WCA has supported a national network of wound centers focused on reducing costs and improving patient outcomes. WCA empowers these centers by seamlessly transitioning from outsourced management to in-house support, leveraging Luvo – the industry's most powerful business intelligence platform. How can WCA support you? Learn more at

We Support
Wound Centers.

It's just that simple.