Healthcare 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
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
“This procedure will require prior authorization.” Words that no patient or healthcare provider wants to hear when they are ready to proceed with a doctor-approved procedure for a medical matter. However, it’s one of the utilization management tools that insurance companies have fostered to decide if specific prescribed procedures, services and medications are medically required […]
Health Insurance, Healthcare, Healthcare Providers, Medical Billing, Medical Credentialing, Medical Practice, Medicare, Prior Authorization, Prior Authorization Process, Revenue, Revenue Cycle, Revenue Cycle Management, Utilization Management
Choose a Qualified Medical Billing Group Since there are a large number of companies offering medical billing services, it’s often difficult for a healthcare provider to choose the best-fit, third party billing group for their organization. Healthcare providers have to ask billing companies the right questions on systems and services rendered, thereby making it much […]
Medical Billing, Medical Coding, Medical Credentialing, Pittsburgh Medical Billing, Pittsburgh Medical Credentialing, Revenue Cycle Management
Denied Medical Claims Prevention 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% […]
Denial Management, Denied Medical Claim Prevention, Denied Medical Claims, Medical Claim Denial, Medical Claims, upstream process