Medicare and Medicaid Fraud Vulnerability 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 […]
Billing for Services Not Rendered, Billing Fraud, False certification, Fraud, Kickbacks, Medicaid, Medicaid Fraud, Medical Billing Fraud, Medicare, Medicare Fraud, Phantom billing, Prescription Drug Fraud, Supply fraud, Unlawful self-referral, Upcoding, Whistleblower, Whistleblower Protection Act
What are ICD-10 Codes? ICD-10 codes are the tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification system used worldwide to classify and code diseases and health conditions. The ICD-10 codes are used by healthcare providers and insurance companies to accurately describe and categorize medical diagnoses, treatments, […]
Healthcare, Healthcare Billing, ICD-10, ICD-10 lookup, ICD-11, Medical Billing, Reimbursement, WHO, World Health Organization
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 […]
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
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
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 ManagementSubmitting 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
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
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
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
Patient Payments in Healthcare are Changing In spite of a “hot-vaxxed summer,” the COVID-19 pandemic lingers, and sadly, even more robustly in some places than ever before. It’s also continuing to take its toll on healthcare consumers, both psychologically and financially. That’s one of several reasons why it’s more critical than ever for healthcare providers […]
Digital Payments, Healthcare, Healthcare Payments, Medical Billing, Medical Digital Payments, Medical Payments, Patient Payments, Payment Trends, Telehealth
Healthcare Patient Billing Expectations Patients believe every aspect of their healthcare experience contributes to their care, including the medical payment and billing process. And a negative payment incident could impact a patient’s overall impression of a healthcare organization, even if the rest of their experience was positive. According to survey results, patient satisfaction ratings fall […]
Billing, Billing Service, Healthcare, Medical, Medical Bill, Medical Bill Process, Medical Claims, Medical Patients, Medical Payment
How Does Pricing Work in Medical Billing? The 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 […]
Basics of Medical Billing, Billing, Healthcare Billing, Medical Billing, Medical Billing Service, Medical Provider Billing, Outsource Medical billing, Pittsburgh Medical Billing, RCM, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization
Medical Billing and Credentialing Made Easy “There just has to be an easier way to perform our billing and credentialing.” If you’ve had to perform your own billing and credentialing, you know exactly what we’re talking about. For any number of healthcare practices, in-house billing and credentialing is an unpleasant, yet necessary, chore. This is […]
Billing, Credentialing, Medical Billing, Medical Billing Companies, Medical Credentialing
The healthcare industry is vast and complex, even more so for mental health providers. This is especially true when it comes to the mental health billing process. The variety in the types of services, the time, scope and restraints put on mental health treatments make the billing process quite demanding. If a patient visits his […]
Behavioral Health, Behavioral Health Billing, Behavioral Health Codes, Behavioral Health Reimbursement, Billing, Billing Outcomes, ICD-10, Medical Billing, Medical Coding, Mental Health, Mental Health Billing, Outsource Medical billing, Outsourced Billing, Outsourced Medical Billing
Search for how to choose a medical billing company and nearly every result reads the same way, a numbered checklist written by a billing company trying to sound helpful while it sells you something. Ask about experience. Ask about HIPAA compliance. Ask about references. None of that is wrong, but it is also not what […]
Billing Red Flags, Choosing A Billing Partner, Denial Management, Medical Billing Company, Outsourced Medical Billing
It’s approximated that $3 trillion worth of medical claims are submitted every year to insurance companies, etc., with $262 billion worth of these claims denied. Approximately 65% of the denied medical claims are not resubmitted to the organization which denied the claim. Statistical data indicates that commercial payers are denying 58% of those claims. Appealing […]
Denial Management, Denials Managements, Denied Medical Claim Prevention, Denied Medical Claims, Medical Billing, Medical Billing Companies, Medical Billing Outsourcing, Medical Claim Denial, Medical Claims, Patient Billing, Patient Medical Billing, Revenue Cycle Management, upstream process