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 […]
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How Does Outsourcing Toxicology Billing Maximize Revenue Collection?
Outsourcing Toxicology Billing Maximizes Profit As a supplier of toxicology testing, you’re well aware that medical billing for toxicology laboratory work is highly complex and undergoes frequent and often unpredictable changes. Further muddying the waters, lab testing work is an area of attention and scrutiny by agents for the Office of Inspector General and the […]
billing revenue, Medical Billing, Revenue Cycle, toxicology billing, toxicology lab billing, toxicology laboratory billing, toxicology labsHospital Revenue Cycle Challenges
Revenue Cycle Challenges Frequently Experienced by Hospitals Data suggests that many hospitals find it increasingly difficult to scale and guarantee high revenue cycle performance. As we all know, hospitals have a large number of expenses. It’s crucial that they receive prompt patient payments from insurance companies, etc. It’s vital for all hospital departments to work […]
Hospital Billing, Hospital Medical Billing, Hospital Revenue Cycle, Medical Revenue Cycle, Revenue Cycle, Revenue Cycle Management10 Reasons to Outsource Your Medical Billing
Whether you’re a physician, practice manager, or anyone else charged with overseeing the billing operations for a healthcare organization, let me start by saying – I feel your pain. Medical billing has always been one of the most maddeningly complex, persistently stressful parts of running a modern medical practice. In today’s healthcare landscape, it just […]
billing, billing services, Healthcare Billing, HIPAA, HIPAA Compliant, Medical Billing, Medical Billing and Coding, medical billing services, Medical Billing Tips, outsourced billing, outsourced medical billing, Outsourcing Medical BillingOBGYN
Billing in the field of obstetrics and gynecology (OBGYN) is a complex and multifaceted process that requires a thorough understanding of medical coding, insurance regulations, and practice management strategies. Efficient billing practices are essential for ensuring timely reimbursement, maintaining a healthy revenue cycle, and providing quality care to patients. We’ll delve into the intricacies of […]
Mastering Charge Capture: A Roadmap for Healthcare Providers
If you’re a healthcare provider, you know how important it is to get paid accurately and on time for the services you provide. But the revenue cycle management process can be a tangled web of codes, documentation requirements, and insurance rules. One of the biggest pain points? Charge capture. Charge capture is the process of […]
billing, Charge Capture, Charge Capture Challenges, Charge Capture Strategy, Denials, EHR, EMR, Medical Billing, Missed Charges, Optimized Charge Capture, Revenue Cycle Management, Revenue LeakageHow to Choose The Right Clearinghouse Services
Clearinghouses play a crucial role in facilitating the electronic exchange of data between providers, payers, and other entities. Clearinghouses act as intermediaries, converting data from proprietary formats used by different systems into standardized formats that can be understood by all parties involved. With so many clearinghouse options available, selecting the right one can be a […]
CAQH CORE Certification, clearinghouse, EHNAC Accreditation, EHR, EHR Integration, EMR, EMR integration, HIPAA Compliance, HL7, HL7 interoperability, HL7 Standards, Regulatory Compliance, Value-Added ServicesWhich Medical Billing Technologies Should Healthcare Providers Adopt?
If you’re a healthcare provider, dealing with medical billing is probably one of your least favorite parts of the job. It’s a total pain – keeping track of patient information, filing claims, following up on denials, and ensuring you actually get paid for your services. And let’s be honest, the medical billing process is incredibly […]
A/R, Billing Tech, Billing Technologies, Business Intelligence, Claim Scrubbing, Data Analytics, Denials, EHR, EMR, KPIs, Patient Portals, RPA, Rules-Based Claim ScrubbingMedicare Reimbursement: Understanding the Labyrinth
If you’re a healthcare provider or facility dealing with Medicare, one thing is certain – getting properly reimbursed is a maze filled with complex rules, convoluted paperwork, and often, sheer frustration. Medicare reimbursement is the lifeblood that keeps many healthcare operations afloat, but navigating its serpentine pathways can feel like a daily battle. Buckle up […]
APC, APCs, CMS, Geographical Practice Cost Index, healthcare, Healthcare Billing, Inpatient Prospective Payment System, IPPS, Medical, Medical Billing, medicare, medicare billing, Medicare Part A, Medicare Part B, Medicare Part C, Medicare Part D, Medicare Physician Fee Schedule, Medicare Reimbursement, Medicare Severity Diagnosis Related Groups, MIPS, MS-DRG, OPPS, Prospective Payment Systems, Revenue Cycle, Revenue Cycle ManagementHow Robotic Process Automation is Replacing Manual Entry in Medical Billing
Let’s be real – medical billing can be a huge pain. For those who perform it internally and externally. At times, it’s one of those mind-numbingly tedious tasks that makes you question your career choices. Hours upon hours of copying and pasting data from one system to another, checking and re-checking codes, filling out endless […]
Automation, Billing Automation, EHR, EMR, EMR Data Extraction, EMR RPA, Medical Billing Automation, Robotic Process Automation, Robotic Process Automation Billing, Robotic Process Automation Medical Billing, RPA, RPA AdoptionWhich CPT Codes are Used in Remote Patient Monitoring Billing?
If you’re a healthcare provider looking to get into remote patient monitoring (RPM), one of the first things you need to understand is how to bill for these services. And that starts with knowing the right CPT codes to use. RPM has been around for a while, but it really took off during the COVID-19 […]
99091, 99453, 99454, 99457, 99473, 99474, billing, CPT codes, Healthcare Billing, Medical Billing, rcm, Remote Patient Monitoring, Remote Patient Monitoring Billing, Remote Patient Monitoring CPT Codes, Revenue Cycle Management, RPM, RPM Billing, RPM CPT CodesWant to Start a Medical Billing Company?
So you want to start your own medical billing company? It’s a lucrative industry with a ton of potential, but also one that requires some specialized knowledge and an understanding of the healthcare system. Don’t worry though, I’m going to walk you through all the key steps for getting a medical billing business off the […]
billing, healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Startup, rcm, RCM Startup, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, Start a Medical Billing Company, Start Your Own Medical Billing CompanyPathology
Efficient revenue cycle management has become a critical component of running a successful pathology practice. From coding and billing to insurance claim submissions and denial management, the intricate processes involved in medical billing can be overwhelming for many healthcare providers. This is where pathology billing services come into play, offering a comprehensive solution to streamline […]
Streamline Your Medical Billing Workflow: Best Practices for Efficiency
Efficient medical billing processes are crucial for maintaining a healthy revenue cycle and to ensure the financial well-being of healthcare providers. With the increasing complexity of payer regulations, coding intricacies, and patient expectations, medical billing workflows can quickly become convoluted and inefficient, leading to costly delays, errors, and dissatisfied patients. Fortunately, through the implementation of […]
billing, Billing Challenges, Billing Workflow, Coding Intricacies, EHR, Electronic Health Records, EMR, Future-Proof, healthcare, Healthcare Billing, Interoperability Standards, Medical, Medical Billing, Medical Billing Service, Medical Billing Workflow, NLP, Payer Regulations, Practice Management Systems, rcm, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, Streamlined Medical Billing WorkflowUnderstanding the Latest Healthcare Regulatory Changes Impacting RCM
The healthcare industry is dynamic, and staying up-to-date with the latest regulatory changes is crucial for efficient Revenue Cycle Management (RCM). RCM encompasses the processes involved in tracking and collecting patient service revenue, from the initial registration and appointment scheduling to the final payment of balances. Failure to comply with regulatory requirements can result in […]
Affordable Care Act, Coding and Documentation, Cybersecurity, Data Privacy, Environmental Sustainability, Health Equity, HIPAA, Interoperability, No Surprises Act, Non-Discrimination Regulations, Patient Access, Price Transparency, Regulatory Changes, Regulatory Compliance, Regulatory Requirements, telehealth, Value Based Care, Virtual Care RegulationsData Analytics for RCM: Turning Numbers into Actionable Insight
In today’s data-driven world, healthcare organizations are swimming in an ocean of information. From electronic health records to claims data, patient surveys to online reviews, the sheer volume of data can be overwhelming. However, this data holds the key to unlocking insights that can vastly improve revenue cycle management (RCM) processes and drive better financial […]
artificial intelligence, Big Data, Cloud Computing, Data Analytics, Data Democratization, Internet of Things, IoT, Machine Learning, Predictive Analytics, Prescriptive Analytics, RCM Data Analytics, Self-Service AnalyticsHow Leading Providers Optimized Their RCM Performance
The healthcare revenue cycle management (RCM) process is a complex and critical set of activities that encompasses everything from patient registration and appointment scheduling to final payment collection. With rising costs, shrinking reimbursements, and increasing regulatory burdens, optimizing RCM performance has become essential for provider organizations to ensure financial viability and sustainability. In this article, […]
billing, Case Studies, Charge Capture, Denial Analytics, denial management, Denial Trends, healthcare, Medical, Medical Billing, rcm, RCM Case Studies, RCM Optimization, Revenue, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, Revenue Cycle Process, Revenue Integrity10 Key Medical Billing Challenges and Solutions
The medical billing process is a complex and often daunting task for healthcare providers. From keeping up with ever-changing regulations and coding updates to managing denials and claim rejections, medical billers face numerous challenges that can significantly impact revenue cycle management and the financial health of a practice. In this comprehensive article, we’ll explore ten […]
A/R, A/R Management, Benefits Verification, COB, Coding Accuracy, denial management, HIPAA, HIPAA Compliance, Patient Eligibility, Payer Contracting, Revenue Cycle Management, Revenue Cycle Process, revenue optimization, Timely Claim SubmissionThe Top 10 Trends in Medical Billing Software
The healthcare industry has undergone massive changes in recent years, largely driven by advances in technology and data. One area seeing significant innovation is medical billing software. These new solutions are transforming how healthcare providers handle billing, collections, reporting, and revenue cycle management. In this article, we will explore the top 10 emerging trends in […]
Billing Analytics, Billing Dashboard, Cloud-Based Systems, denial management, Payment Plan Flexibility, Practice Management Integration, Real-Time Eligibility Checks, Robotic Process Automation, RPA, Self-Service Portals, Total Revenue Integrity, Workflow Rules EnginesWhat are and When to Use Modifier Codes
Modifier codes are an important part of medical billing and coding. They provide additional information about a medical procedure or service to help ensure proper reimbursement. Knowing when to use modifier codes can improve claim accuracy and prevent costly payment delays or denials. This comprehensive guide will explain what modifier codes are, why they are […]
Anatomic Modifiers, Bilateral Surgery Modifiers, billing, Coding, coding and billing, CPT, CPT definitions, CPT-10, Global Surgery Modifiers, HCPCS, healthcare, Healthcare Billing, Medical, Medical Billing, medical coding, medical necessity, NCCI, NCCI Edits, payer policies, Procedure Modifiers, Revenue Cycle, Revenue Cycle Management, revenue cycle optimizationTop Strategies to Drastically Reduce Claim Denial Rates in 2024
Claim denials continue to be a persistent challenge for healthcare providers in 2024. The costly administrative burden of denied claims and appeals, coupled with lower revenues and margins, puts increasing pressure on organizations to find ways to prevent denials and increase collections. The good news is there are proven strategies providers can implement to proactively […]
Appeals management, Authorizations, claim denial prevention, denial rates, documentation, medical necessity, patient demographic/insurance data, patient insurance eligibility, Pre-certifications, preventable denial rates, Reducing Denials, verificationThe Essential Guide to Medical Billing Automation
Medical practices are constantly looking for ways to improve efficiency and increase revenue. Yet many practices are still relying on manual, paper-based billing processes that are tedious, error-prone, and time-consuming. In today’s digital age, automated medical billing is a must for any practice that wants to streamline operations, get paid faster, reduce denied claims, and […]
AI, artificial intelligence, automated billing, automating billing, billing, Billing Automation, Cloud-based automation, EHR, healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Automation, medical billing strategy, rcm, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, Robotic Process Automation, RPA5 Common EHR Gaps and How to Fill Them
Electronic health records (EHRs) have become a core component of healthcare operations. When used effectively, EHRs can improve care coordination, increase efficiency, and provide valuable data insights. However, many healthcare organizations struggle to fully leverage their EHR investments. Gaps in EHR adoption and usage lead to workflow inefficiencies, poor data quality, and suboptimal care. In […]
care gap identification, Clinical Decision Support Underutilization, Coding Gaps, Data Silos, Data Transparency, EHR, EHR (Electronic Health Records), EHR adoption, EHR gaps, EHR Integration, Electronic Health Records, healthcare, healthcare analytics, Medical, Medical Analytics, Medical workflow inefficiencies, Patient Portal Underutilization, Reporting LimitationsPharmacogenetic (PGx) Testing
Pharmacogenetic (PGx) Testing Billing and Reimbursement Pharmacogenetic (PGx) testing analyzes how genes affect a person’s response to medications. This emerging field of precision medicine allows clinicians to optimize drug therapy selections and dosing based on a patient’s genetic makeup. As PGx testing becomes more widespread, medical practices face challenges with insurance coverage, coding, and reimbursement. […]
Telehealth Billing
Telehealth has become an increasingly popular way for patients to access healthcare services remotely. With telehealth, patients can consult with doctors, therapists, and other providers through video chat, phone calls, or mobile apps instead of going into a clinic or hospital. As telehealth usage grows, understanding how to bill and get reimbursed for these virtual […]