Achieving Revenue Cycle Optimization The healthcare industry is changing rapidly, creating a host of challenges for healthcare providers. Cutbacks in reimbursements, bad debt and regulatory reforms all affect a provider’s revenue. Moreover, the failure to recognize claim submission mistakes heightens the risk of inadequate reimbursement and even nonpayment. While concentrating on ever-pressing needs, it’s difficult […]
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Common Revenue Cycle Management Mistakes Is Your Revenue Cycle Management in Top-Notch Condition? Let’s face it, we all make mistakes, even as veterans in revenue cycle management. Sometimes, though, our biggest mistakes are the ones right under our noses – the ones we simply don’t identify as mistakes because we’ve been making them for so […]
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Revenue Cycle Management Challenges If a healthcare provider doesn’t set up an efficient billing process, it runs the risk of losing quite a bit of money. With high-deductible insurance plans becoming more widespread, patients are shelling out additional money out of pocket. Or, if the patient is uninsured or underinsured, problems arise since there’s not […]
A/R, A/R Process, A/R Recovery, Accounts Receivable, Healthcare Billing, Healthcare Outcomes, healthcare revenue cycle, Measuring Healthcare Outcomes, Medical Billing, medical claims, Medical Revenue Cycle, Patient Billing, Patient Collections, Revenue Cycle Management
Have Your Patients Been Charged with Surprise Bills for COVID-19 Testing? No doubt, the Delta-variant is the driving force behind a new flood of nationwide testing that could translate into more surprise medical bills for those being tested. The CARES Act and Families First Coronavirus Relief Act are supposed to ensure free COVID-19 testing for […]
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Measuring Healthcare Outcomes Healthcare Practice Key Performance Indicators Matter So, your healthcare practice is running smoothly. You’ve hired fantastic people, followed a marketing plan, placed the right technology and your patient retention policy is in full swing with a low churn rate. Things are going great, right? Well, there’s no way of really knowing for […]
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The Reasons Why a Medical Billing Assessment is Needed Medical Billing Assessments Running a healthcare practice means keeping a tight ship for the sake of your patients and your reputation, as well as your financial well-being. But, let’s face it, practices are only as successful as their medical billing performance. If you have a prosperous […]
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Outsourced COVID-19 Testing Billing Advantages COVID-19 Testing Scenario Jude Hunt, 81 years old, said she waited in line for her second PCR test a few weeks ago after her vaccinated housekeeper tested positive for COVID-19. She said she previously contracted COVID herself and received the vaccine, but added, “After the last two years, I’m not […]
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The Gravity of Ethical Medical Billing Practices The Hypothetical Case of Dr. Michael Stevens’ Unethical Medical Billing Behavior The case of Dr. Michael Stevens is an illustration of the worst-case scenario when unethical behavior impacts medical billing. An anesthesiologist and owner of a pain management clinic, Dr. Stevens was obliged to relinquish his medical license […]
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7 Strategies to Maximize Patient Collections Any medical provider knows how difficult it is to get paid for their services. 73 percent of healthcare providers assert that it takes 30+ days to recover their payment fully. Various issues like complicated billing procedures, changing payer fee schedules, employee attrition, government directives, lack of training and resources […]
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Understanding Medical Billing Myths Dr. John Smith owns a small practice in Pittsburgh’s South Hills. He’s in the midst of a conversation with one of his nurses. Nurse: “Doctor, do you think we should be posting signs concerning the payment of co-pays once the patient is finished with their appointment?” Doctor: “I agree to a […]
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Patient Flow Increases Revenues No longer can healthcare practices rely on the single appointment and waiting room process. Managers of healthcare practices of all types and sizes increasingly recognize that effective patient flow is key to increasing revenue and improving efficiency for the practice as well as providing a positive experience for the patient. As […]
Medical Billing, medical patient flow, medical patients, patient flow
Healthcare Practice Revenue Affected by Medical Billing Issues Let’s say a patient comes in and gives you his or her Medicare card. The front desk carefully records the information and billing submits the charge to Medicare. But the claim is rejected, maybe even from the clearinghouse. The problem? The patient thinks he’s simply on Medicare, […]
Healthcare Billing, Medical Billing, Medical Billing Service, medical claims, Outsource Billing, Outsource Medical billing, outsourced billingHealthcare Practices Save Money with Higher Accuracy of Medical Claims Reimbursement for medical practices has been impacted by numerous trends and healthcare industry changes over the past five to ten years. Medicare and Medicaid are constantly cutting physician reimbursement, third-party payers (UnitedHealth, BCBS, Humana, Anthem, Aetna, Cigna, etc.) have bargained for fee-for-service contracts with healthcare […]
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Outsourcing Toxicology Billing Maximizes Profit As a supplier of toxicology testing, you’re well aware that medical billing for toxicology laboratory work is highly complex and undergoes frequent and often unpredictable changes. Further muddying the waters, lab testing work is an area of attention and scrutiny by agents for the Office of Inspector General and the […]
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Top Medical Billing Companies 2021 by SuperbCompanies We are excited to announce that Medwave Billing & Credentialing has been named one of the top Medical Billing Companies 2021 by SuperbCompanies. With more than 20 years of experience, we have accumulated many accomplishments, and each award is special for us. A huge team of experts works […]
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Medicare, Medicaid Fraud Examples and Steps to Ensure You Don’t Commit It A medical doctor invoiced his patient’s Medicare insurance for both the services he actually delivered and for services that were not delivered. He fabricated his patient’s medical records to indicate office visits and treatments that never took place. A gerontologist obtained the outcomes […]
billing fraud, false claims act, fraud, medicaid, medicaid billing, medicaid fraud, medical billing fraud, medicare, medicare billing, medicare fraud, upcodingMedical Billing Service Costs How Does Pricing Work in Medical Billing? The most familiar question medical billing companies hear, “What are your prices?” It’s an entirely reasonable question. After all, price is a sizable component in any business decision. In this article, we’ll try to clarify some of the misunderstandings surrounding medical billing service rates. […]
Basics of Medical Billing, Healthcare Billing, Medical Billing, Medical Billing Service, medical provider billing, Outsource Medical billing, Pittsburgh Medical BillingWhat’s a 3rd Party Medical Billing Service? Where’s the Value for a Healthcare Provider? The Basics of Medical Billing As a healthcare provider, you wear quite a few hats. Chances are medical billing might be one of them. But is there a better way? Let’s discuss the advantages for your healthcare practice to consider outsourcing […]
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Medical Billing and Credentialing Made Easy “There just has to be an easier way to perform our billing and credentialing.” Does any of this sound familiar? I’m tired of dealing with insurance companies! I got into healthcare because I wanted to focus on patients, not paperwork and red tape! I’d rather do without having to […]
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Allergy Billing Options The complexities of allergy billing Allergy immunotherapy (aka allergy shots) is the recurrent administration of specific allergens to individuals with immunoglobulin E(IgE)-mediated condition. The goal is to reduce or stop the allergy by diminishing the strength of the IgE response. These treatments, being patient specific, can have serum mixed for up to […]
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Behavioral Health Billing Case Study Type of Practice: Behavioral Health Group The Challenge: A successful behavioral health practice approached Medwave to manage their billing process. Up until now, they were performing their own billing in-house using various staff members who had had some formal training. However, they were finding that these staff members were spending […]
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Health Insurers and Prior Authorization Like sands through the hourglass, so are the days of prior authorization “This procedure will require prior authorization.” Words that no patient or healthcare provider wants to hear when they are ready to proceed with a doctor-approved procedure for a medical matter. However, it’s one of the utilization management tools […]
health insurance, healthcare, healthcare providers, Medical Billing, medical credentialing, medical practice, prior authorization, utilization managementCOVID-19 Billing for Lab Testing The federal government announced a Public Health Emergency in response to the COVID-19 pandemic, effective January 27, 2020. While the healthcare industry has been continually adapting to new information and new regulatory challenges, one thing that has stayed constant is the need for rapid, frequent and reliable COVID-19 lab testing. […]
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Are You Committed to Outsourcing Your Substance Abuse Billing? So, you’re determined to outsource your substance abuse billing. That’s a smart move, since you’ll save time and ultimately money. After all, no one gets into the substance abuse field because they want to wade through the insurance industry bureaucracy. No, you became substance abuse specialists because […]
Medical Billing, opioid addiction, Opioid Addiction Billing, Outsource Billing, Outsource Medical billing, Outsourcing Medical Billing, substance abuse, Substance Abuse BillingBilling and Coding Partner for Healthcare Medwave is a premier provider of medical billing and coding services. But, exactly why are billing and coding so important and how can Medwave help your healthcare center perform these functions? It’s certainly no surprise that the healthcare business is thriving, and its growth is projected to endure well […]
Healthcare Billing, HIPPA, Medical Billing, medical coding