Billing & Credentialing Cranberry Twp. (Pittsburgh)
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Call: (412) 219-4789 | Fax: (866) 422-9277
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Unbundling

What’s the Difference Between Comprehensive, Component, and Modifier Codes?

February 9, 2024 / admin / Articles, Billing, Bundled Payments, Bundling, Component Codes, Comprehensive Codes, CPT Manual, Healthcare, Healthcare Billing, Medical, Medical Billing, Modifier Code, Modifiers, Unbundling
Medical CPT Codes

Medical billing and coding is an intricate process that requires the use of different types of codes to accurately document procedures, services, diagnoses, and supplies. Three important types of codes are comprehensive codes, component codes, and modifier codes. Understanding the differences between these code types is crucial for accurate medical billing and reimbursement. Comprehensive Codes […]

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-AS, -AT, -CG, -LT, -RT, Adjunct Services, ancillary services, Billing, Bundling, Care Settings, Component Codes, Comprehensive Codes, CPT Manual, Healthcare, Healthcare Billing, Laterality, Medical, Medical Billing, Modifier Codes, Modifiers, Patient Conditions, RCM, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization, Unbundling, Unusual Circumstances

The Essential Guide to Avoiding Improper Bundling in Medical Billing

February 6, 2024 / admin / Articles, Bundling, Component Codes, Improper Bundling, Medical Billing, Medically Unlikely Edits, Modifier Code, Modifier Codes, Modifiers, MUEs, National Correct Coding Initiative, NCCI, NCCI Edits, Proper Bundling, Unbundling
White Female Medical Billing Outsourced

Improper bundling in medical billing can lead to denied claims, payment delays, audits, fines, and even fraud allegations. As a medical billing professional, it’s crucial to understand how to bundle procedures correctly to ensure proper reimbursement while adhering to CMS guidelines. In this guide, we’ll cover everything you need to know about avoiding improper bundling […]

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Claim Denials, Component Codes, Comprehensive Code, CPT, CPT codes, Denied Claims, Denied Medical Claims, HCPCS, Medically Unlikely Edits, Modifier Codes, MUEs, National Correct Coding Initiative, NCCI, NCCI Edits, Unbundling

Top Coding and Billing Errors to Avoid

September 5, 2023 / admin / Articles, Authorization Failures, Bad Sequencing, Benefits Errors, Billing, Billing Duplicates, Duplicate Coding, EOB Errors, Expired Policy Numbers, Grouping Errors, Insufficient Modifiers, Invalid Linkages, Invalid Place of Service, Missing Codes, Missing Modifiers, Poor Handwriting, Timed Coding Errors, Unbundling
Medical Billing White Guy

Accuracy in both medical coding and billing processes is imperative for maximizing appropriate reimbursement, maintaining regulatory compliance, and optimizing revenue cycle performance. Even minor errors can have major consequences in delayed or reduced payments, denied claims, and compliance risks. We cover the most common coding and billing mistakes along with best practices to identify where […]

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Authorization Failures, Bad Sequencing, Benefits Errors, Billing, Billing Duplicates, Duplicate Coding, Duplication, EOB Errors, Expired Policy Numbers, Grouping Errors, Inaccurate Patient Info, Inaccurate Patient Information, Inadequate Specificity, Incorrect Code Assignments, Incorrect Units, Insufficient Modifiers, Invalid Linkages, Invalid Place of Service, Medical Billing, Missing Codes, Missing Modifiers, Poor Handwriting, Timed Coding Errors, Timeliness Issues, Unbundling, Upcoding

Common Examples of Medicare, Medicaid Fraud

May 8, 2021 / admin / Articles, False Claims Act, Fraud, Medicaid, Medicaid Fraud, Medicaid Fraud Examples, Medicare, Medicare Fraud, Medicare Fraud Examples, Phantom Billing, Unbundling, Upcoding
Medicare Fraud

Medicare, Medicaid Fraud Examples and Steps to Ensure You Don’t Commit It A medical doctor invoiced his patient’s Medicare insurance for both the services he actually delivered and for services that were not delivered. He fabricated his patient’s medical records to indicate office visits and treatments that never took place. A gerontologist obtained the outcomes […]

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Billing Fraud, False Claims Act, Fraud, Medicaid, Medicaid Billing, Medicaid Fraud, Medicaid Fraud Examples, Medical Billing Fraud, Medicare, Medicare Billing, Medicare Fraud, Medicare Fraud Examples, Upcoding

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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

  • Florida Medical Billing, Credentialing

    Florida Medical Billing, Credentialing: The Sunshine State’s Standards

  • 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?

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