Billing & Credentialing Cranberry Twp. (Pittsburgh)
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  • Claim Rejection Rate

Claim Rejection Rate

What is a Clean Claim Rate?

October 12, 2024 / admin / Articles, Billing, Billing KPIs, CCR, Claim Denial, Claim Denial Prevention, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Clean Claim Rate, Revenue Cycle, Revenue Cycle Management
electronic-claim-attachments

In healthcare revenue cycle management, few metrics carry as much weight as the Clean Claim Rate (CCR). This crucial key performance indicator (KPI) serves as a fundamental measure of a healthcare organization’s billing efficiency and effectiveness. As healthcare providers face increasing pressure to optimize their revenue cycles while maintaining high-quality patient care, understanding and improving […]

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billing, Billing KPIs, CCR, Claim Denial, claim denial prevention, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Clean Claim Rate, Revenue Cycle, Revenue Cycle Management

Claim Denial vs. Rejection: What’s the Difference?

February 23, 2024 / admin / Articles, Claim Denial, Claim Denial Prevention, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Claims Management, Clearinghouse Rejection, Denial Management, Denial Prevention Strategy, Denial Trends, Denial vs Rejection, Denied Claims, Denied Medical Claims, Payer Rejection, Rejected Claims
Medical Claim Denied Doctor

In the healthcare industry, there are two main ways that insurance companies respond when they decide not to pay a claim – denial and rejection. Both indicate the claim will not be paid, but there are some important differences between the two. Understanding the distinction is critical for medical providers to correctly follow-up so they […]

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Claim Denial, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Clearinghouse Rejection, Denial vs Rejection, denied claims, healthcare, Healthcare Billing, Medical, Medical Billing, Payer Rejection, rcm, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization

Strategies for Dealing with Denied Claims

February 21, 2024 / admin / Articles, Billing, Claim Denial Prevention, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Denial Analytics, Denial Codes, Denial Management, Denial Prevention Strategy, Denial Trends, Denials Managements, Denied Claims, Denied Medical Claims

Dealing with denied claims is one of the most frustrating and time-consuming aspects of medical billing. However, there are several strategies billing staff can employ to efficiently handle denials, appeal them successfully, and prevent denials from occurring in the first place. We analyze the most effective ways to deal with denied claims in medical billing. […]

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billing, claim denial manager, Claim Denials, Claim Rejection, Claim Rejection Rate, denial management, Denial Prevention, Denial Prevention Strategy, Denial Trends, Denials, denied claims, Healthcare Billing, Medical Billing, rcm, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization

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

Navigating 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 […]

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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

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Practices Served

  • Behavioral Health
  • DME
  • Genetic Testing
  • Urgent Care
  • Pharmacogenetic (PGx) Testing
  • Toxicology
  • Substance Abuse
  • Allergy Testing
  • Speech Therapy
  • Skilled Nursing Facilities
  • Oncology
  • Pathology
  • OBGYN
  • 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
  • Genetic Testing
  • Urgent Care
  • Pharmacogenetic (PGx) Testing
  • Toxicology
  • Substance Abuse
  • Allergy Testing
  • Speech Therapy
  • Skilled Nursing Facilities
  • Oncology
  • Pathology
  • OBGYN
  • 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

  • American Independence; Healthcare Business Freedom

    Healthcare Provider Freedom: Declaring Independence from Administrative Tyranny

  • Healthcare Provider Data Management

    What is Healthcare Provider Data Management?

  • Credentialing Needed Female Medical Doctor

    Medicare Modifiers: a Complete Guide

  • White Male Medical Doctor Holding Stethoscope

    Competency-Based Credentialing in Healthcare

  • White Male Medical Doctor Needs Credentialing

    The Worst Credentialing Problems and How to Solve Them

  • Asian Male Doctor in Need of Credentialing

    What are the Main Types of Medical Credentials?

  • California Medical Billing, Credentialing

    Managing California’s Medical Billing and Credentialing Needs

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