Telestroke and teleneurology refer to the use of telehealth to provide acute stroke care and neurological care from a distance. This allows neurologists and stroke specialists to evaluate and manage patients in hospitals or clinics that may not have specialty care available onsite. The use of telehealth and virtual care models in neurology has grown enormously […]
Articles posted by Alex J. Lau
Which CPT Codes are Used in Biologics and Specialty Drugs Billing?

Biologics and specialty drugs represent some of the most innovative and specialized pharmaceuticals available today. They are used to treat a wide range of diseases and conditions, from cancers to autoimmune disorders. However, these cutting-edge medications also come with high price tags and layered administration requirements. One of the tools used to properly bill and […]
Additional Injectable Drugs, Biologics and Specialty Drugs CPT Codes, Infusible Biologics, Injectable/Infusible Biologics, Interferons10 Medical Coding Mistakes That Could Cost You

Medical coding is a complex and detail-oriented job. Even experienced coders can make mistakes that lead to costly errors and compliance issues. Avoiding common coding mistakes is crucial for accurate reimbursement, proper record-keeping, and avoiding penalties. Medical coding is highly intricate, yet accuracy is critical for proper reimbursement, compliance, and data reporting. Even minor coding […]
Common Coding Errors, E/M coding, Incorrect E/M, National Correct Coding Initiatives, UnbundlingNew Medicare Modifiers XE, XP, XS, XU: Examples of When to Bill Each One

Effective January 1, 2022, the Centers for Medicare & Medicaid Services (CMS) introduced four new HCPCS modifiers for Medicare claims: XE, XP, XS, and XU. These modifiers provide more specificity around the circumstances of service provided. Using these new modifiers correctly is essential for ensuring accurate reimbursement. We provide an overview of modifiers XE, XP, […]
Medicare Modifiers, Modifier XE, Modifier XP, Modifier XS, Modifier XUBilling Workers’ Compensation: A Guide to Making Claims Through HR

Workers’ compensation provides benefits to employees who suffer job-related injuries or illnesses. It covers medical treatment, lost wages, and rehabilitation services. Workers’ comp is regulated at the state level and all businesses are required to have workers’ comp insurance. When an employee is injured on the job, they need to file a claim with their […]
Denied Workers’ Compensation Claims, Human Resources, Insurance Adjusters, Workers’ Comp Claim, Workers’ Compensation BillingThe Top 10 Trends in Medical Billing Software

The healthcare industry has undergone massive changes in recent years, largely driven by advances in technology and data. One area seeing significant innovation is medical billing software. These new solutions are transforming how healthcare providers handle billing, collections, reporting, and revenue cycle management. We analyze the top 10 emerging trends in medical billing software. Knowing […]
Denial Management, Real-Time Eligibility Checks, Robotic Process Automation, Self-Service Portals, Workflow Rules EnginesManual Medical Billing is Dead, RPA is the Answer

Medical billing has long relied on manual data entry and paperwork to process claims. But this antiquated approach is no longer sustainable in today’s digital healthcare environment. The future of medical billing lies with robotic process automation (RPA). RPA automates repetitive data entry and workflow tasks, increasing efficiency, reducing human error, and allowing medical billers […]
Billing Automation, HL7, Revenue Cycle Management, RPAWhat are and When to Use Modifier Codes

Modifier codes are an important part of medical billing and coding. They provide additional information about a medical procedure or service to help ensure proper reimbursement. Knowing when to use modifier codes can improve claim accuracy and prevent costly payment delays or denials. We explain what modifier codes are, why they are used, the most […]
Anatomic Modifiers, Bilateral Surgery Modifiers, Global Surgery Modifiers, Medical Coding, Procedure ModifiersWhat’s the Difference Between Comprehensive, Component, and Modifier Codes?

Medical billing and coding is an intricate process that requires the use of different types of codes to accurately document procedures, services, diagnoses, and supplies. Three important types of codes are comprehensive codes, component codes, and modifier codes. Knowing the differences between these code types is crucial for accurate medical billing and reimbursement. When to […]
Adjunct Services, Bundling, Laterality, Modifier Codes, ModifiersImproper Bundling in Medical Billing: NCCI Rules, Common Errors, How to Stay Compliant

Improper bundling in medical billing occurs when services that should be billed under a single CPT code are instead billed as separate component codes to generate higher reimbursement, a practice CMS classifies as unbundling. The inverse error, combining services that should be billed separately under a single code, results in underpayment and lost revenue. Both […]
Component Codes, Comprehensive Codes, Improper Bundling, Modifier Codes, UnbundlingThe Complete Guide to Fixing Common Medical Billing Errors

Improve revenue, reduce denials, and ensure compliance by following these expert billing tips for healthcare providers. Frequent billing mistakes can hurt your medical practice’s bottom line. Discover the most common medical billing errors, their financial impact, and proven steps to prevent them. This extensive billing guide for providers, clinics, and medical billers will help fix […]
Diagnosis Code Errors, Incorrect Modifiers, Medical Billing Errors, Missing Pre-Authorizations, Procedure Code MistakesThe Essential Guide to Medical Billing Automation

Improper bundling in medical billing occurs when services that should be billed under a single CPT code are instead billed as separate component codes to generate higher reimbursement, a practice CMS classifies as unbundling. The inverse error, combining services that should be billed separately under a single code, results in underpayment and lost revenue. Both […]
Artificial Intelligence, Billing Automation, Revenue Cycle Management, Robotic Process AutomationWhich CPT Codes are Used in Oncology Billing?

Oncology billing involves the use of many complex CPT codes to accurately report services provided to cancer patients. Choosing the right codes is critical for ensuring proper reimbursement and compliance with billing guidelines. We provide an overview of the most common CPT codes used in oncology billing and coding. Evaluation and Management (E/M) Codes E/M […]
Chemotherapy CPT Codes, Nuclear Medicine Services, Oncology Billing, Oncology Coding Reimbursement, Oncology CPT Codes10 Trends Set to Transform Medical Billing

The healthcare industry is rapidly evolving, driven by advances in technology, changes in regulations, and shifts in consumer behavior. For medical billing professionals, these changes bring both opportunities and challenges. Staying up-to-date on the latest trends is key to remaining competitive and providing the best possible service to healthcare providers. We’ll explore the top 10 […]
Artificial Intelligence, Big Data, Revenue Cycle Management, Robotic Process Automation, TelehealthHow to Connect an EHR to a Clearinghouse: A Step-by-Step Guide

Electronic health records (EHRs) have become an indispensable part of healthcare operations. EHRs allow providers to store patient information electronically and share it securely. However, to transmit claims and other data to payers, providers need to connect their EHR system to a clearinghouse. A clearinghouse acts as an intermediary between providers and insurance companies by […]
Clearinghouse, EMR, HL7, Interoperability, Revenue Cycle ManagementWhich CPT Codes are Used in Speech Therapy Billing?

Speech-language pathology services are critical for evaluating and treating communication disorders, swallowing difficulties, and cognitive-linguistic impairments. However, selecting the proper CPT codes for speech therapy can be complex given the many types of assessments, modalities, and interventions provided. We examine the most frequently used Current Procedural Terminology (CPT) codes that speech therapists report to receive […]
CPT Codes, Evaluation Codes, Medical Billing, Speech Billing, Speech Therapy BillingStaffing Shortages Force New Medical Billing Strategies

The healthcare industry is facing a critical staffing shortage that is impacting medical billing operations and revenue cycle management. With an aging population and expanded access to healthcare, the demand for healthcare services is rising. However, there is a shortage of healthcare workers, including medical billers and coders, to meet this growing demand. This is […]
Medical Billing Staff, Outsourced Billing, RCM, Revenue Cycle Optimization, Robotic Process AutomationMedical Providers and the Untapped Potential of HL7

The healthcare industry has undergone massive changes in recent years, fueled by advances in technology and a shift towards patient-centered care. However, one area that still has untapped potential is the use of Health Level 7 (HL7) standards. HL7 provides a framework for exchanging clinical and administrative data between software applications used by various healthcare […]
EHR Integration, FHIR, Interoperability, Medical Billing, RPAWhich CPT Codes are Used in Nursing Facility Billing?

Nursing facilities fulfill a critical role in the post-acute care continuum by providing rehabilitation and custodial care services to patients not yet ready to transition home after hospitalization. The range of skilled nursing services offered enables recovery and stabilization for populations such as post-surgical patients, those with newly diagnosed illnesses requiring education and management, individuals […]
CPT Codes, Medical Billing, Nursing Facility Evaluation, Skilled Nursing Billing, Skilled Nursing FacilitiesHow AI is Transforming Healthcare: 12 Real-World Use Cases

Artificial intelligence has moved from hype to mainstream adoption across healthcare, unlocking new possibilities for improving patient outcomes, experiences, and access to care. Below, we’ll explore 12 impactful real-world use cases showing exactly how healthcare providers are leveraging different AI models to enhance clinical workflows, augment decision making, streamline operational processes, and advance precision medicine. […]
AI Diagnostic Models, HIPAA, KPIs, Patient Care, Use Case
