ICD-10 codes are the tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification system used worldwide to classify and code diseases and health conditions. The ICD-10 codes are used by healthcare providers and insurance companies to accurately describe and categorize medical diagnoses, treatments, and procedures. ICD-10 codes […]
Healthcare, ICD-10 lookup, ICD-11, Medical Billing, Reimbursement
Uncompensated Healthcare in the Form of Charity Care and Bad Debt are Painful for Providers Uncompensated care is a widespread pain point for healthcare organizations, rising by just over a billion dollars in 2020 to $42.7 billion. And while it may not be thinkable to get rid of it, there are tactics you can introduce […]
Charity Care, Charitycare, Healthcare, Healthcare Debt, Medical, Medical Care, Medical Charity, RCM, Revenue Cycle Management (RCM), Uncompensated Healthcare
As a healthcare provider, your goal is to help people. However, this type of work is unsure at times. If a healthcare worker makes a misstep, they could harm a person’s health. Even if there hasn’t been any maltreatment or mistake on the part of the healthcare practitioner, disagreements can result when physicians’ and patients’ […]
General Liability, General Liability Insurance, Health Insurance, Healthcare, Healthcare Practice, Insurance, Medical, Medical Billing, Medical Credentialing, Medical Practice
What’s the Difference Between a Skilled Nursing Facility and a Nursing Home? On the surface, a skilled nursing facility and a nursing home may appear rather the same. In fact, some care facilities actually function as both, with a distinct floor or section of a building dedicated to each. The difference between a skilled nursing […]
Billing, Medical Billing, Medical Billing Service, Nursing Billing, Nursing Facility Billing, Nursing Home, Old Folks Home, Skilled Nursing, Skilled Nursing Billing, Skilled Nursing Facility, Skilled Nursing Facility Billing
Why Your Patients are Failing to Use Your Portal Properly Patient Portal Challenges Healthcare consumers vary from tech-savvy Generation Z, Y and Millennials, familiar with rapid click-throughs, to straightforward answers, to patients with little or no faith or proficiency in computing tools. In any instance, just a few words can sum up the probable value-added […]
Confusion, Medical Patients, Medical Practice, Patient Portal, Patient Portal Problems, Security
Submitting Electronic Claim Attachments One of the major strains on healthcare providers is the dependence on paper and manual procedures. This duo frequently adds up to harmful mistakes and costly denials, which demand significantly more time and effort to resolve, if left unchecked. Among the manual processes most difficult to manage are claim attachments that […]
Clearinghouse, EHR, Electronic Claim Attachments, Electronic Claims, EMR, Medical Billing, Medical Billing Software, Medical Billing Team, Medical Billing Tool, Outsourced Billing, Outsourced Medical Billing, RCM, Revenue Cycle Management
Social Media and Patient Privacy in Healthcare A Few Use Cases Use Case #1: Use Case #2: Protected Health Information (PHI) Preserving privacy of patients’ protected health information (PHI) is one of the major concerns linked to social media in healthcare. Privacy and protection of such information are dealt with in federal law and overseen […]
Facebook Healthcare, HIPAA, HIPAA Compliant, Instagram Healthcare, Internet HIPAA, Medical Billing, Medical Credentialing, Patient Privacy, PHI, Privacy, Safety Violations, Social Media, Social Media Healthcare, Social Media HIPAA, Social Media Medical
Hiring new providers brings energy and growth to any medical practice. Whether you’re bringing on a physician, nurse practitioner, or physician assistant, adding talented healthcare professionals to your team opens doors to serving more patients and expanding your services. But there’s a catch that trips up even experienced practice managers, getting these new providers ready […]
Credentialing, credentialing on-boarding, Enrollment, Healthcare, Healthcare Credentialing, Medical Credentialing, Payer Enrollment
Artificial Intelligence (AI) is a hot topic right now with many speculating on how it will change the way we live our lives. In fact, we’ve already discovered that in the medical field there are numerous ways that AI can be employed to improve overall performance. As a prime example, medical billing and coding have […]
Artificial Intelligence, Billing AI, Billing and Coding, EHR, RPA
COVID-19 Upset Provider-Payer Relationships The COVID-19 pandemic has affected most, if not all, businesses everywhere. For healthcare, in particular, the pandemic and its consequences altered the ways that payers and providers do business with one another. Let’s catch a momentary peek at several of the more immediate effects on provider-payer relationships, consisting of upturns in […]
Provider-Payer Relationship
No matter the industry, artificial intelligence (AI) has become routine and commonplace. When it comes to healthcare, AI helps practitioners streamline tasks, expand operational efficiencies and simplify complicated medical procedures. AI in medical billing and coding is becoming increasingly more crucial. Although AI is certainly transforming the healthcare industry, this technology is still quite new. As […]
AI, AI Healthcare, Healthcare Outcomes, Real-time Data
What is Robotic Process Automation? When you come across the term “robotic process automation,” you might think it sounds rather futuristic. However, RPA, as it’s often termed, is a technology being deployed more and more in the healthcare industry, including medical billing. Robotic process automation (software) consists of tools that partly or fully automate human […]
Billing Automation, Billing RPA, EHR, EHR RPA, EMR, EMR RPA, Health Level 7, HL7, Insurance, Medical Billing, Medical Billing Automation, Medical Billing Robotic Process Automation, Medical Billing RPA, RCM, Revenue Cycle Management, Robotic Process Automation, Robotic Process Automation Billing, Robotic Process Automation Medical Billing, RPA, RPA Billing
“Revenue leakage” describes circumstances wherein a healthcare provider has supplied care to a patient but doesn’t collect payment. In general, it happens when accounts receivable (AR) continue to be unpaid for too long and are inadvertently overlooked. The longer an account receivable remains outstanding, the less likely healthcare providers are to retrieve payment, even in […]
A/R, Healthcare, Healthcare Denials, Healthcare Reimbursement, Healthcare Revenue Cycle, Medical Billing, Medical Billing Denials, RCM, RCM Challenges, RCM Essentials, RCM Support
Healthcare has been under real strain these past few years, and the effects haven’t just shown up in exam rooms. Patients have felt the pressure both psychologically and financially, as economic uncertainty, job disruptions, and gaps in insurance coverage left many struggling to keep up with medical bills they didn’t see coming. That kind of […]
Healthcare Payments, Medical Billing, Medical Digital Payments, Patient Payments, Payment Trends
An Unethical Medical Billing Behavior Case 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 when it was uncovered that his in-house medical biller was committing fraud. […]
Ethical Medical Billing, Healthcare Ethics, Medical Billing Ethics, Medical Billing Fraud
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 […]
Basics of Medical Billing, Collection Process, Medical Billing, Medical Billing Strategies, Medical Billing Strategy, Outsourced Medical Billing, Patient Collections
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 […]
Healthcare Billing, Healthcare Providers, Medical Billing, Medical Billing Myths, Medical Billing Service, Outsource Billing, Outsource Medical billing, Outsourced Billing, Pittsburgh Medical Billing
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 Billing
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 […]
Billing Revenue, Medical Billing, Revenue Cycle, Toxicology Billing, Toxicology Lab Billing, Toxicology Laboratory Billing, Toxicology Labs
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 in the undermentioned content, we’ll try to clarify some of the misunderstandings surrounding medical billing service rates. We’ll also attempt to present some of the factors […]
Billing Fees, Billing Percentage, Fixed Rate Billing, Medical Billing Cost, Outsourced Billing
Allergy immunotherapy billing runs on a different clock than most specialties. A single patient’s serum can stay in rotation for up to a year, moving through build-up dosing, then maintenance dosing, with the injection codes changing depending on whether the practice is billing single or multiple antigen injections at the same visit. Miss that distinction […]
Allergy Immunotherapy Billing, Immunologist Billing, Immunology Billing, Outsourced Billing
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. “This procedure will require prior authorization.” However, it’s one of the utilization management tools that insurance companies have fostered to decide if specific prescribed procedures, services and medications are medically required […]
Prior Authorization Process, Revenue Cycle Management
Truth is, many patients know little more about their physician’s qualifications than what they see neatly hanging from their office wall. While they’re able to access in-depth background information about their auto mechanic, it’s when they are at their most vulnerable, entrusting their family’s health to a qualified healthcare professional, is when they must hope […]
Credentialing Value, Payor Enrollment, Provider Credentialing
What is Medical Billing? Medical billing is the process of submitting and following up on claims with health insurance companies to receive payment for services rendered by a healthcare provider. It involves coding and classification of diseases, procedures, and treatments and submission of claims to insurance companies for reimbursement. The goal of medical billing is […]
Claims Preparation, Claims Submission, Medical Billing Powerpoint, Medical Coding, Payment Posting
It’s looming, in the coming months or next year, many financial experts foresee an inevitable economic recession in the United States and elsewhere. A large downturn in the economy will adversely affect the aspect of most people’s lives. Their finances, lifestyle and healthcare. Initially, the effect(s) of a recession on the healthcare sector may not […]
AAFP, Recession