What is Genetic Testing? Genetic testing is a medical process that involves analyzing a person’s DNA, the building blocks of their genes, to look for specific changes that can indicate the presence of a genetic disorder or an increased risk of developing a certain condition. Genetic testing can be used to diagnose a variety of […]
What is Medical Credentialing? Medical credentialing is a vital process for ensuring the quality of healthcare services. It involves verifying the education, training, and professional experience of healthcare providers to ensure that they meet the standards for practicing in their field. This process helps to ensure that patients receive safe, effective, and appropriate care from […]
Credentialing, Healthcare, Healthcare Credentialing, Medical, Medical Credentialing, What is Medical Credentialing
Substance abuse refers to the harmful use of drugs or alcohol with negative consequences on an individual’s health, relationships, and daily life. The term encompasses a range of substance use disorders, including addiction and abuse, and is a growing concern in the United States and around the world. Substance abuse is a complex issue that […]
Opioid, Opioid Addiction, Opioid Addiction Billing, Overdoses, SAMHSA, SBIRT, SBIRT reimbursement, Substance Abuse and Mental Health Services Administration
COVID-19 has brought the world to a standstill, and the demand for effective testing has skyrocketed. In this blog post, we will discuss COVID-19 test kit reimbursement and the different types of kits available. It depends on the country and healthcare system, but generally COVID-19 test kits are reimbursed if they are performed in a […]
COVID-19, COVID-19 billing, COVID-19 test kit, COVID-19 test kit billing, COVID-19 test kit reimbursement, COVID-19 test kits, COVID-19 testing
Medical Billing: Basics, Role of Specialists, Challenges, RPA and What to Look for in a Company Medical billing is an important aspect of the healthcare industry that plays a crucial role in ensuring that patients receive the medical treatment they need while healthcare providers are reimbursed for the services they offer. The process involves submitting […]
Billing Accuracy, HIPAA, HIPAA Compliant, Medical Billing, Medical Billing Compliance, Medical Billing Customer Service, Medical Billing Expertise, Medical Billing Robotic Process Automation, Reimbursement Rates, Robotic Process Automation, RPA
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 up […]
AI, Artificial Intelligence, Artificial Intelligence Healthcare, COVID, COVID-19, Data Security, Machine Learning, Medical Billing, RCM, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization
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 denial management strategy to recognize, solve, recover and avoid denied […]
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
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 Rates
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, Interoperability, Interoperability Standards, Medical Billing
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
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 […]
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, RPA
Telehealth 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
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, AI medical, Artificial Intelligence, Artificial Intelligence Healthcare, Healthcare, Healthcare KPIs, Healthcare Outcomes, Medical Billing
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
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
Your Revenue Cycle Management Status Healthcare providers faced a tidal wave of challenges at the beginning of the COVID-19 pandemic, many of which endure consequences today. It’s not surprising that the revenue cycle did not evade these challenges. The shutdown and transfer to a generally virtual care world presented substantial bedlam that the revenue cycle […]
RCM, RCM Challenges, RCM Essentials, Revenue Cycle Challenges, Revenue Cycle Management, Revenue Cycle Management Concerns, Revenue Cycle Management Issues, Revenue Cycle Optimization