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
In the wake of months of social distancing and virtual visits during the COVID-19 pandemic, patients are once again veering towards a need to see their physicians in person. As patient volume recovers, it’s a great time to take a look at a healthcare practice’s Revenue Cycle Management (RCM) program and make sure it’s still […]
AI, Artificial Intelligence, Artificial Intelligence Healthcare, COVID, COVID-19, Data Security, Machine Learning, Medical Billing, RCM, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization
Overcome Claim Denials Claim Denials are Challenges for Healthcare Providers Even healthcare providers who deploy safeguards to dodge insurance payment hazards, occasionally find themselves up against a claim denial. Taking care of denied insurance claims can be a frustrating process for healthcare practitioners and their office staff. That’s why it’s vital to utilize a claim […]
Billing, Claim Denial, Claim Denials, Claim Rejections, Denial Management, Denied Medical Claim Prevention, Denied Medical Claims, Healthcare, Healthcare Billing, Medical, Medical Billing, Medical Claim Rejections, Medical Claims, Medical Payor, RCM, Revenue Cycle Management
Is Revenue Integrity Critical in Healthcare? What is Revenue and Why is it Important? The exact wording may vary, but you can look for terms such as “gross revenue,” “gross sales,” or “total sales.” This figure is the amount of money a business brought in during the time period covered by the income statement. The […]
Healthcare, Healthcare Revenue, Healthcare Revenue Integrity, Medical Revenue Integrity, Revenue, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization, Revenue Integrity
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
HL7: Building the Connection Between Healthcare and IT What Exactly is HL7? HL7 (Health Level Seven)Â is a standard for swapping health information between medical applications. This standard identifies a format for the transmission of health-related information. Information transmitted using the HL7 standard is sent as a collection of one or more messages. Each message sends […]
Healthcare Delivery, Healthcare Format, Healthcare HL7, HL7, HL7 Standards
Let’s begin with this set-up: Let’s say you’re hunting for a new job and receive a call from a would-be employer informing you that the job is yours. Of course, you’re thrilled by the news and inquire about your starting salary. Your new employer replies that you need to wait for your first paycheck to […]
Credentialing, Healthcare Credentialing, Medicaid, Medicare, Private Insurers, Provider Credentialing, Provider Networks, Reimbursement RatesBringing new providers aboard is invigorating, yet a complex process with plenty of moving parts. If you’ve ever had the opportunity to hire a physician or mid-level professional, you know just how much work is involved. Payer enrollment is maybe one of the more essential, yet misunderstood pieces of the puzzle. No doubt, making your […]
Credentialing, credentialing on-boarding, Enrollment, Healthcare, Healthcare Credentialing, Medical Credentialing, Payer Contract, Payer Contracting, Payer Enrollment
EHR Systems + Medical Billing Integration Medical billing and practice management has long been a labor-intensive task for healthcare providers. There’s little doubt, however, that the use of EHR (Electronic Health Records) or sometimes known as EMR (Electronic Medical Records) has considerably slashed these tasks by offering providers a proven method to effectively streamline their […]
Billing, Billing AI, Billing Automation, Billing Revenue, Billing Service, EHR, EHR (Electronic Health Records), EHR Integration, EHR Interoperability, Electronic Health Records, Electronic Medical Records, EMR, EMR (Electronic Medical Record), Health Level 7, HL7, Insurance, Interoperability, Interoperability Standards, Medical Billing
Improving Patient Telehealth Experience Telehealth Assessment Gaining access to healthcare has become even more essential than ever. The COVID-19 pandemic didn’t prevent healthcare workers from discharging their oath and tackling medical issues quickly and properly. In fact, the use and popularity of telehealth expanded significantly in response to the COVID-19 pandemic. An assessment of telehealth […]
Healthcare, Healthcare AI, HIPAA, HIPPA Compliant, Medical Providers, Telehealth, Telehealth Delivery, Telehealth Experience, Telehealth Improvements, Telehealth Services, Telehealth Software, Telemedicine, Telemedicine Improvements
What Healthcare Providers Need to Know about Vaping Both the U.S Food & Drug Administration and the Centers for Disease Control are working determinedly to look into the disturbing occurrences of severe respiratory illness connected with the use of vaping products. Both organizations are diligently working with state and local health officials to investigate these […]
Cancer, CDC, e-cigarette, EHR, Healthcare, Lung Association, Vape, Vape Pen, Vaping, Vapor
Medical Practice Management Challenges Solved by Outsourced Medical Billing Quality, Outsourced Medical Billing is the Answer The billing team at Capitol Healthcare practice had been reaching a high bar of excellence. But that bar was endangered when long-time staff members began to retire. “Some of the staff had been here for a long time, like […]
Healthcare Billing, Insurance, Medical Billing, Medical Billing Service, Medical Billing Strategy, Medical Credentialing, Outsource Billing, Outsource Medical billing, Outsourced Billing, Outsourced Medical Billing, Revenue Cycle Management, Revenue Cycle Optimization
Example of AI in Medical Billing and Coding 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 […]
AI, Artificial Intelligence, Artificial Intelligence Healthcare, Billing, Billing AI, EHR, EHR RPA, Health Level 7, Healthcare AI, HL7, Insurance, Medical Billing, Medical Billing AI, Medical Billing Artificial Intelligence, RPATelehealth is Useful, but is it Here to Stay? Maybe we really don’t want to talk about it, but truth is, major calamities like the COVID-19 pandemic often lead to innovations in healthcare. As a prime example, the use of virtual care skyrocketed as people, asked to socially distance, looked for substitutes for in-person visits. […]
AI, AI in Healthcare, AI in Telehealth, AI Telehealth, Corona, Corona Virus, Coronavirus, COVID, COVID-19, Healthcare, Healthcare Delivery, Healthcare Outcomes, Ian Tong, Meg Barron, Telehealth, Telehealth AI, Telemedicine
Provider-Payer Relationship Under COVID-19 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. How So? Let’s catch a momentary peek at several of the more immediate effects on […]
Coronavirus, Coronavirus billing, COVID billing, COVID test kits, COVID testing billing, COVID-19, COVID-19 testing, Healthcare Billing, Medical Billing, Outsourced Billing, Outsourced Medical Billing, Provider-Payor
Advantages and Disadvantages of Using Artificial Intelligence (AI) in Healthcare 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 […]
AI, AI Healthcare, AI medical, Artificial Intelligence, Artificial Intelligence Healthcare, Healthcare, Healthcare KPIs, Healthcare Outcomes, Medical Billing
Robotic Process Automation (RPA) in Medical Billing What Exactly 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 […]
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
Behavioral / Mental Health Services + Medicare Sometimes it can be problematic for older adults to differentiate indicators of mental health difficulties for typical aging-related changes. They may think that experiencing sadness or anxiety is an ordinary symptom of growing older, particularly when they live with taxing health conditions or lose loved ones. Deteriorating health […]
Behavioral Health, Behavioral Health Billing, Medicaid, Medicare, Medicare Coverage, Medicare Therapy, Mental Health, Mental Health Billing
Home Health Services + Medicare What does Medicare Cover for Home Healthcare? If you’re looking for an answer to the question, “What does Medicare cover for home healthcare?”, you’ve probably typed it into a search engine and immediately closed the tab. The amount of information and the level of detail can quickly become confusing and […]
Healthcare, Healthcare Services, Home Health Care, Home Health Services, Home Healthcare, Medicaid, Medicaid Billing, Medicaid Coverage, Medicare, Medicare Billing, Medicare Coverage
Medicare, Medicaid Fraud Examples and Steps to Ensure You Don’t Commit It *These are examples of fraud as it relates to Medicare and Medicaid. Medical fraud is the intentional deception or misrepresentation of healthcare transactions by the provider for the sake of receiving unauthorized benefits or financial gain. Healthcare fraud is committed when a dishonest […]
Billing Fraud, False Claims Act, Fraud, Medicaid, Medicaid Billing, Medicaid Fraud, Medicaid Fraud Examples, Medical Billing Fraud, Medicare, Medicare Billing, Medicare Fraud, Medicare Fraud Examples, Upcoding