Every healthcare provider knows the feeling. It starts with a subtle knot in your stomach as you review the day’s claims submissions. Your mind races through the endless possibilities of what could go wrong: Was the diagnosis code correct? Did we document everything properly? Will this claim be denied… again? Welcome to “Claimxiety” – that […]
billing, Billing Worries, Claims Management, Claims Management Challenges, Claimxiety, Clean Claim Rate, Medical Billing, Medical Billing Errors, Medical Claim Denials, Medical Claim Rejection, medical claims
Medical providers face numerous challenges when it comes to getting paid for their services in a timely manner. Between complicated insurance requirements, claim denials, and administrative burdens, it can often take weeks or even months for providers to receive payment. This cash flow bottleneck can put significant financial strain on medical practices and hospitals. One […]
healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Service, medical billing strategy, Outsource Medical billing, outsourced billing, outsourced medical billing, Revenue Cycle Management, revenue cycle optimization
Medicare and Medicaid Fraud is a Massive Healthcare Industry Problem 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 […]
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
Overcome Claim Denials Claim Denials are Challenges for Healthcare Providers 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 […]
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
Why Your Patients are Failing to Use Your Portal Properly Patient Portal Challenges Healthcare consumers vary from tech-savvy Generation Z, Y and Millennials, familiar with rapid click-throughs, to straightforward answers, to patients with little or no faith or proficiency in computing tools. In any instance, just a few words can sum up the probable value-added […]
confusion, medical patients, medical practice, patient portal, patient portal problems, security
Interested in Stopping Revenue Leakage? Firstly, Let’s Define Revenue Leakage “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 […]
A/R, healthcare, healthcare denials, healthcare reimbursement, healthcare revenue cycle, Medical Billing, medical billing denials, rcm, rcm challenges, rcm essentials, rcm support
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
The healthcare industry is changing rapidly, creating a host of challenges for healthcare providers. Cutbacks in reimbursements, bad debt and regulatory reforms all affect a provider’s revenue. Moreover, the failure to recognize claim submission mistakes heightens the risk of inadequate reimbursement and even nonpayment. While concentrating on ever-pressing needs, it’s difficult for providers to spot […]
healthcare revenue cycle, Medical Billing, Outsource Billing, Outsource Medical billing, outsourced billing, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, revenue loss, revenue optimization
Revenue Cycle Management Challenges If a healthcare provider doesn’t set up an efficient billing process, it runs the risk of losing quite a bit of money. With high-deductible insurance plans becoming more widespread, patients are shelling out additional money out of pocket. Or, if the patient is uninsured or underinsured, problems arise since there’s not […]
A/R, A/R Process, A/R Recovery, Accounts Receivable, Healthcare Billing, Healthcare Outcomes, healthcare revenue cycle, Measuring Healthcare Outcomes, Medical Billing, medical claims, Medical Revenue Cycle, Patient Billing, Patient Collections, Revenue Cycle Management
The Gravity of Ethical Medical Billing Practices The Hypothetical Case of Dr. Michael Stevens’ Unethical Medical Billing Behavior 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 […]
Basics of Medical Billing, Ethical Medical Billing, healthcare ethics, Medical Billing, Medical Billing Ethics, medical billing fraud
Healthcare Practice Revenue Affected by Medical Billing Issues 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, […]
Healthcare Billing, Medical Billing, Medical Billing Service, medical claims, Outsource Billing, Outsource Medical billing, outsourced billingHealthcare Practices Save Money with Higher Accuracy of Medical Claims Reimbursement for medical practices has been impacted by numerous trends and healthcare industry changes over the past five to ten years. Medicare and Medicaid are constantly cutting physician reimbursement, third-party payers (UnitedHealth, BCBS, Humana, Anthem, Aetna, Cigna, etc.) have bargained for fee-for-service contracts with healthcare […]
healthcare rcm, healthcare revenue cycle, HIPAA, Medical Billing, medical claim accuracy, medical claims, outsourced billing, outsourced medical billing, rcm, Revenue Cycle Management, revenue loss