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, 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
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
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 Collections
Medical Billing Myths FAQ 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: […]
Healthcare Billing, Healthcare Providers, Medical Billing, Medical Billing Myths, Medical Billing Service, Outsource Billing, Outsource Medical billing, Outsourced Billing, Pittsburgh Medical Billing
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, 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
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, COVID, Healthcare
Health care providers should periodically review their financials and revenue cycle, so that they can take corrective measures at the earliest if required. A great deal of medical offices / health care providers find that medical billing is one area which could be drastically improved. Using the latest medical billing techniques, a provider’s efficiency and […]
AI, Automated Billing, Automation, EHR, RPA
Healthcare in a digital environment is complicated, particularly with the numerous regulations that seem to be constantly rolling out additional layers. Healthcare providers are spending more time and resources as they organize patient care, and this time could be put to better use. Using a qualified, outsourced behavioral health billing company can provide better service […]
Behavioral Health Billing, Mental Health, Mental Health Billing, Outsourced Billing
Credentialing for healthcare providers, hospital groups and facilities is a tedious task that often requires a team of specialists to handle all the on-boarding information, as well as updates throughout the year. As of April, 2018, CMS now mandates that providers maintain accurate information and timely updates. Providers and facilities that do not keep up […]
CAQH, Credentialing Applications, In-Network, NPPES, PECOS, Primary Source Verification