Medical billing is a crucial aspect of the healthcare industry, responsible for accurately tracking and processing payments for patient care and services. In recent years, advances in technology have led to the development of Robotic Process Automation (RPA) in Healthcare, which has been hailed as a game-changer for many industries, including healthcare. In this article, […]
Caims Generation Submission, FHIR, HL7 Standards, Insurance Coverage Verification, Medical Billing RPA, Payment Processing, Robotic Process Automation
Uber Health is now active in 28 states and Lyft Healthcare in 21, and both work through Medicaid managed care plans and NEMT brokers rather than through the consumer app most people already have on their phone. That’s a significant shift from a few years ago, when these platforms were still mostly pilot programs. If […]
Healthcare Transportation, Lyft Healthcare, Medical Appointments, Medical Transportation, NEMT Billing, Non-Emergency Medical Transportation, Uber Health
Medical Billing has its Difficulties Medical billing is an intricate process that involves various steps to ensure that healthcare providers receive payment for their services. Onboarding a new medical billing system can be a daunting task, but it can also bring about significant improvements in the efficiency and accuracy of the billing process. Examples of […]
Billing Accuracy, Billing Software, Medical Billing Onboarding, Outsourced Billing
The Medicare and Medicaid programs provide crucial support to millions of Americans, offering access to healthcare services for those who may not otherwise be able to afford it. Unfortunately, these programs are also vulnerable to fraud, with criminals exploiting the system to enrich themselves at the expense of taxpayers and patients. Medicare fraud and Medicaid […]
Medicaid, Medicare, Phantom billing, Upcoding, Whistleblower Protection Act
Uncompensated care cost U.S. hospitals close to $745 billion between 2000 and 2022, and the number keeps climbing. Some of that spike traces back to Medicaid redeterminations that resumed in 2023, when states rechecked eligibility for the first time since the pandemic and more than 19 million people lost coverage. A patient who had Medicaid […]
Charity Care, Healthcare, Healthcare Debt, Medical Care, Medical Charity, Uncompensated Healthcare
Updated October 2026 Medwave first published this page in December 2022, the same month HHS proposed a national standard for electronic claim attachments. That proposal sat for more than three years. The final rule appeared in the Federal Register on March 24, 2026, and every HIPAA covered entity now has until May 26, 2028 to […]
CAQH Index, Denial Management, Electronic Claims, Medical Billing Software, RCM
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 […]
CAQH, DataSpring, Medical Credentialing, Payer Enrollment, Primary Source Verification
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
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, HL7, Medical Billing Automation, Robotic Process Automation, 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 […]
AR Cycles, Medical Billing, Patient Centricity, RCM, Revenue Leakage
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
Patient Collections Strategies FAQ 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 […]
Basics of Medical Billing, Collection Process, Medical Billing, Medical Billing Strategies, Patient CollectionsLet’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, but his plan is actually with Blue Cross, […]
Diagnostic Code, Healthcare Billing, Medical Billing Service, Medical Claims, Outsourced Billing
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 U.S. Department of Justice. In […]
Billing Revenue, Outsourced Toxicology Billing, Revenue Cycle, Toxicology Billing, Toxicology Lab BillingThe 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 […]
Billing and Coding, Medical Billing, Prior Authorization Process, Reimbursement, 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, NCQA, Outsourced Credentialing, Payer 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 […]
Billing Service, Medical Billing Powerpoint, Medical Billing PPT, Medical Billing Video