Billing & Credentialing Cranberry Twp. (Pittsburgh)
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Claim Data

Brace for Impact: Managing the Surge of New Medical Billing Regulations

November 27, 2023 / admin / Articles, Billing, Billing Regulations, Billing Revenue, Claim Data, Good Faith Estimates, Health Level 7, Healthcare, HL7, Interoperability, Medicaid, Medical Billing Regulations, Medicare, No Surprises Act, Pre-Authorization
Medical Billing Software White Male User

As US healthcare costs continue rising steeply – now over $4 trillion representing nearly 20% of GDP – both federal and state policymakers urgently seek ways to contain runaway expenditure growth. This drive manifests through expansion of programs like Medicare Advantage and Medicaid managed care coupled with accelerating passage of game-changing legislation like No Surprises […]

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Billing, Billing Best Practice, Billing Disruption, Billing Revenue, Claim Data, Consumer-Centered Billing, Good Faith Estimates, Health Level 7, Healthcare, HL7, Interoperability, Medicaid, Medical Billing Regulations, Medicare, No Surprises Act, Pre-Authorization

Evolving Medical Billing Talent Strategies: The Rise of Offshoring and Outsourced Models

November 25, 2023 / admin / Articles, Billing, Billing Automation, Billing Best Practice, Billing Revenue, Billing RPA, Billing Services, Claim Data, Claims Management, Healthcare, Healthcare Billing, HIPAA, HIPAA and Data Protection, HIPAA Compliant, HL7, Medical Billing, Offshore Billing, Outsourced Billing
Offshore Medical Billing

Medical billing involves the complex processes of coding services, generating insurance claims, managing rejection disputes, and ultimately securing optimal reimbursement for healthcare providers. With mounting administrative burdens and revenue pressures facing US healthcare systems, demand has accelerated for skilled medical billing talent. However, tight labor markets have spurred shortages. Below, we analyze the spreading adoption […]

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Healthcare, Healthcare Billing, HIPAA, HIPAA Compliant, HL7, Medical, Medical Billing, Offshore Billing, Outsource Medical billing, Outsourced Billing, Outsourced Medical Billing, RCM, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization, Robotic Process Automation, RPA

Decoding Medical Claims: an Introductory 101 Guide

November 22, 2023 / admin / Articles, Billing, Charge Capture, Claim Billing, Claim Data, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Claim Status, Claim Transmission, Claims Management, Coding, First Pass Rate, High Claim Volumes, Patient Dissatisfaction, Provider Dissatisfaction, Regulatory Exposure, Suboptimal Claims
White Female Medical Billing Outsourced

Managing insurance claims represents one of the most vital yet complex aspects of running a successful medical practice. Claim submission impacts cash flow, revenue realization, and provider satisfaction. For staff new to healthcare administration, the terminology and processes around medical claims can seem confusing. We analyze the fundamentals in simple terms, from types of insurance […]

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Charge Capture, Claim Denial Rate, Claim Rejection Rate, Claim Transmission, Claims Lifecycle Management, Claims Management Challenges, First Pass Rate, High Claim Volumes, Patient Dissatisfaction, Provider Dissatisfaction, Regulatory Exposure, Suboptimal Claims

Must-have Metrics for Measuring Medical Billing Success

September 27, 2023 / admin / Articles, Billing, Billing Revenue, Billing Services, Claim Data, Claim Denials, Claim Rejection, Coding, CPT Code, Healthcare, Healthcare Billing, Healthcare KPIs, Healthcare Outcomes, Healthcare Revenue, Medical Billing, Medical Billing AI, Medical Billing Analytics, Medical Billing Service, Revenue Cycle Management
White Female Medical Billing Outsourced

Medical billing is a complex, numbers-driven process. To elevate revenues and efficiency, healthcare practices must constantly measure, analyze and optimize their medical billing and revenue cycle performance using key metrics. The Importance of Analytics in Medical Billing In the dynamic healthcare landscape, data is king. Medical practices that succeed at leveraging data make better decisions […]

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CPT Code, Healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Analytics, Medical Billing Service, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization, Robotic Process Automation

Which CPT Codes are Used in Hospitalist Billing?

August 2, 2023 / admin / Articles, Billing, Billing Revenue, Billing Services, Claim Billing, Claim Data, Claim Denials, CPT Codes, Denial Management, Denied Claims, Denied Medical Claims, Healthcare, Healthcare Billing, HL7, Hospitalist, Hospitalist Billing, Hospitalist Medicine, ICD-10, Medical, Medical Billing
Medical Billing Software White Male User

In the realm of medical billing and coding, precision and accuracy are paramount. Hospitalist billing, a specialized area, relies on specific CPT (Current Procedural Terminology) codes to ensure proper reimbursement for services rendered. These codes serve as a universal language that communicates medical procedures and services to insurance companies. In this comprehensive guide, we’ll delve […]

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99221, 99231, 99233, 99238, CPT codes, CPT Codes in Hospitalist Billing, Healthcare, Healthcare Billing, Hospitalist, Hospitalist Billing, Hospitalist Medical Billing, ICD-10, Medical, Medical Billing, Medical Billing Service

EDISS Connect: All You Need to Know

February 15, 2023 / admin / Articles, Claim Data, Data Management, EDI, EDISS, EDISS Connect, EDISS Connect Account, Medical Claim Data, Medical Data, Medical Data Management
Medical Billing Outsourced

What is EDISS Connect? EDISS Connect is a powerful web-based application that allows healthcare providers to manage their claims data more effectively. With its user-friendly interface and advanced features, the EDISS platform streamlines the claims submission process, tracks payment status, and provides powerful reporting tools to help providers analyze their financial transactions. If you’re a […]

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EDI, EDISS, EDISS Connect, Medical Billing, Outsource Billing, Outsource Medical billing, Outsourced Billing, Outsourced Medical Billing, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization

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Practices Served

  • Behavioral Health
  • DME
  • Urgent Care
  • Speech Therapy
  • Geriatric Medicine
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Genetic Testing
  • Pharmacogenetic (PGx)
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

Practices Served

  • Behavioral Health
  • DME
  • Urgent Care
  • Speech Therapy
  • Geriatric Medicine
  • Skilled Nursing Facilities (SNF)
  • Substance Abuse
  • Genetic Testing
  • Pharmacogenetic (PGx)
  • Toxicology
  • Allergy Testing
  • Oncology
  • Pathology
  • OBGYN
  • Internal Medicine
  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

Recent Posts

  • Life Science Lab Doctor Using Microscope AI

    How Artificial Intelligence (AI) is Reshaping Life Sciences

  • White Male Doctor w/ Black Female Administrator

    10 Credentialing KPIs Every Healthcare Provider Should Know

  • Artificial Intelligence Robot Thinking

    How is AI Being Used in Healthcare?

  • Payer Contract Negotiations, with White Male Medical Doctor

    10 Payer Contracting Use Cases

  • White Male Medical Doctor Needing Credentialing

    Struggling with Credentialing? Medwave Can Help!

  • Agreement to Negotiate Contracts in Healthcare

    How to Restructure Payer Contracts

  • White Female Medical Doctor Smiling

    Credentialing for New Graduates: From Residency to Practice

  • Payer Contract Management in Healthcare

    Payer Contract Management Strategies for Healthcare Providers

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