Understanding Medical Billing Myths Dr. John Smith owns a small practice in Pittsburgh’s South Hills. He’s in the midst of a conversation with one of his nurses. Nurse: “Doctor, do you think we should be posting signs concerning the payment of co-pays once the patient is finished with their appointment?” Doctor: “I agree to a […]
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Medical Billing, Credentialing Regions Served
Medical Billing and credentialing are two of the most important healthcare revenue cycle components. It’s crucial to understand every nuance along both paths. Although we are located just north of Pittsburgh, PA (servicing this region for decades) we have serviced many former and current clients, outside of this region, in medical billing and credentialing. Regions […]
What Makes Mental Health Billing So Difficult?
Vexatious Aspects of Mental Health Billing Let’s face it, the healthcare industry is vast and complex, even more so for mental health providers. This is especially true when it comes to the billing process. The variety in the types of services, the time, scope and restraints put on mental health treatments make the billing process […]
Behavioral Health, Behavioral Health Billing, ICD-10, Medical Billing, medical coding, Mental Health, Mental Health Billing, Outsource Medical billing, Pittsburgh Behavioral Health BillingTips for Choosing the Right Medical Billing Company
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 ManagementThe 10 Advantages of Outsourcing Your (Behavioral Health Billing)
10 Advantages of Outsourcing Your Behavioral Health Billing Behavioral Health Billing Healthcare in a digital environment is complicated, particularly with the numerous regulations that seem to be constantly rolling out additional layers. Healthcare providers are spending more time and resources as they organize patient care, and this time could be put to better use. Using […]
Behavioral Health, Behavioral Health Billing, Medical Billing, Mental Health, Mental Health Billing, Outsource Billing, Outsource Medical billing, outsourced medical billing9 Thoughts on Why You Should (Outsource Your Medical Billing)
Outsourced Medical Billing Outsourcing your medical billing and coding to a qualified medical billing staff provides your office with the following: Decrease in office overhead, as outsourcing to our billing team saves time and money Support with operating and setting up Electronic Health Records (EHR) Medical Billing Software Utilizing online portals for electronic billing and […]
Basics of Medical Billing, Billing Medical, Medical Billing, Medical Billing and Coding, medical billing cycle, medical provider billing, new medical practices, Revenue Cycle ManagementA/R Recovery
Accounts Receivables (A/R) Recovery Boosts the Profit of Healthcare Providers Increasingly physicians, clinics, hospitals and healthcare providers are accepting patients who have heath insurance instead of collecting payment directly from the patient using their services. However, some of the health insurance claims of these organizations and professionals are being denied by the insurance companies or […]
About Medwave
Medwave is an efficient and effective solution for providers who are hard-pressed for time and resources. Medical Billing In terms of medical billing, our experienced and professional staff is committed to your practice and we carefully analyze each claim before it is submitted to ensure a clean claim submission. Each claims is examined to see […]
Medical Billing
Medical billing is the process of submitting and following up on claims with health insurance companies in order to receive payment for medical services rendered by healthcare providers. This includes gathering and verifying patient and insurance information, submitting claims for services, reviewing and appealing denials, and tracking payments. It’s an essential part of the healthcare […]
Navigating Fee Schedules and Reimbursement Rates
Few topics get finance teams and medical billing professionals quite as fired up as fee schedules and reimbursement rates. It’s the core of how healthcare providers generate revenue and keep operations humming. At the same time, it’s an arena loaded with complexity, regulatory scrutiny, and often mind-numbing minutiae. If you’re reading this, you’re probably intimately […]
Fee Schedule, Fee Schedules and Reimbursement Rates, Optimizing Reimbursements, reimbursement, Reimbursement Model Shift, Reimbursement Models, Reimbursement Optimization, reimbursement rates, Reimbursement RegulationsWhat’s the Difference Between Institutional and Professional Billing?
If you’ve ever stepped foot in a medical facility or had any kind of healthcare service, you’ve likely encountered the wonderful world of medical billing. But have you ever stopped to think about the different billing methods used? Specifically, the distinction between institutional billing and professional billing? No? Well, buckle up because we’re about to […]
billing, CPT codes, HCFA-1500, HCPCS Codes, Healthcare Billing, ICD Codes, Institutional Billing, Medical Billing, Medical Billing Lingo, Medical Billing Verbiage, Professional Billing, UB-04, UB-04 BillingWhy Outsource Your Credentialing?
Let’s be real – dealing with credentialing is difficult. No healthcare organization truly wants to maintain or balance it. It’s tedious, time-consuming, and can feel like an endless loop of paperwork and verification. But here’s the thing – it’s absolutely crucial. Proper credentialing ensures that your practitioners are qualified and up-to-date, allowing them to get […]
Credentialing, Credentialing Accuracy, Credentialing AI, Credentialing and Contracting, Credentialing Criteria, Credentialing Difficulty, Credentialing New Providers, credentialing on-boarding, medical credentialing, Medical Credentialing AIHandling Denied Claims and Appeals in Medical Billing
Dealing with denied medical claims is one of the biggest headaches in the healthcare revenue cycle. It’s frustrating, time-consuming, and can put a serious dent in your bottom line if not handled properly. But fear not – we’re here to walk you through the process of identifying denials, filing appeals, and hopefully getting those claims […]
Denial Analytics, Denial Codes, denial management, Denial Trends, denied claims, denied medical claimsWhat to Expect When Outsourcing Medical Billing
If you’re a healthcare provider, dealing with medical billing is probably one of your least favorite parts of the job. It’s tedious, complicated, and takes you away from your real passion – caring for patients. That’s why many practices choose to outsource their medical billing to third-party companies that specialize in it. But what does […]
billing, Billing AI, Billing Analytics, Billing KPIs, billing revenue, Billing RPA, Medical Billing, Medical Billing AI, outsourced billing, outsourced medical billing, Outsourcing, Revenue Cycle ManagementStrategies for Dealing with Denied 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. This comprehensive guide will explore the most effective ways to deal with denied claims […]
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 optimizationManual Medical Billing is Dead, RPA is the Answer
Medical billing has long relied on manual data entry and paperwork to process claims. But this antiquated approach is no longer sustainable in today’s digital healthcare environment. The future of medical billing lies with robotic process automation (RPA). RPA automates repetitive data entry and workflow tasks, increasing efficiency, reducing human error, and allowing medical billers […]
Billing Analytics, Billing Automation, healthcare, Healthcare Billing, Manual Billing, Medical, Medical Billing, Medical Billing Robotic Process Automation, rcm, Revenue Cycle, Revenue Cycle Management, Robotic Process Automation, RPA, RPA AdoptionThe Complete Guide to Fixing Common Medical Billing Errors
Improve revenue, reduce denials, and ensure compliance by following these expert billing tips for healthcare providers. Frequent billing mistakes can hurt your medical practice’s bottom line. Discover the most common medical billing errors, their financial impact, and proven steps to prevent them. This comprehensive billing guide for providers, clinics, and medical billers will help fix […]
Automation, Billing Automation, Billing Errors, Common Medical Billing Errors, compliance, Denial Analytics, Diagnosis Code Errors, Incorrect Modifiers, Medical Billing Errors, MGMA, Missing Pre-Authorizations, patient satisfactio, Procedure Code Mistakes, Revenue, RPAThe Reimbursement Model Shift in Medical Billing
The healthcare industry in the United States has undergone massive changes in recent decades. One of the most significant shifts has been in how healthcare providers get reimbursed for services. The traditional fee-for-service model is giving way to value-based models that tie reimbursement to quality of care and patient outcomes. This transformation in reimbursement is […]
Accountable Care Organizations, Billing Operations, Bundled Payments, Capitation, Fee-for-Service, fee-for-service model, P4P, P4P Model, Pay-for-Performance, reimbursement, Reimbursement Disruption, Value Based System, Value-Based Models, Value-based Reimbursement10 Trends Set to Transform Medical Billing
The healthcare industry is rapidly evolving, driven by advances in technology, changes in regulations, and shifts in consumer behavior. For medical billing professionals, these changes bring both opportunities and challenges. Staying up-to-date on the latest trends is key to remaining competitive and providing the best possible service to healthcare providers. In this comprehensive guide, we […]
artificial intelligence, Big Data, Billing RPA, Changing Regulations, Cybersecurity, healthcare, Medical Analytics, Medical Billing, Medical Billing Analytics, Medical Billing Trends, Patient Consumerism, Payment Models, Revenue Cycle Management, revenue cycle optimization, Robotic Process Automation, RPA, telehealth, Virtual CareHow to Take Your Medical Billing to the Next Level in 2024
Medical billing is a complex and ever-evolving field. With constant changes in regulations, coding guidelines, reimbursement rates, and technology, medical billing services must continuously adapt and improve to stay competitive. Taking your medical billing to the next level requires focusing on efficiency, optimization, training, and utilizing the latest tools and software. Implementing the strategies outlined […]
clearinghouse, EDI, healthcare, Healthcare Billing, Medical, Medical Billing, medical billing strategy, rcm, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, Robotic Process Automation, ROI, RPAHow to Connect an EHR to a Clearinghouse: A Step-by-Step Guide
Electronic health records (EHRs) have become an indispensable part of healthcare operations. EHRs allow providers to store patient information electronically and share it securely. However, to transmit claims and other data to payers, providers need to connect their EHR system to a clearinghouse. A clearinghouse acts as an intermediary between providers and insurance companies by […]
clearinghouse, EHR, EMR, healthcare, Healthcare Billing, HL7, HL7 interface, HL7 interoperability, HL7 messaging, HL7 Standards, Medical, Medical Billing, Revenue Cycle Management, revenue cycle optimizationSpeeding Payment Through Strategic, Outsourced Billing
In today’s complex healthcare environment, 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 […]
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 optimizationBridging Healthcare’s Technical and Business Sides: A Guide to Cross-Domain Expertise
Healthcare Expertise Across Technical and Business Domains The healthcare industry is rapidly evolving and becoming more complex. Developing expertise across both technical and business domains is crucial for healthcare organizations to keep up with industry changes and provide high-quality care. This article will explore the importance of cross-functional expertise in healthcare and provide actionable insights […]
Cross-functional, Healthcare Business, Healthcare Ecosystem, Healthcare Operations, Healthcare Technology, Healthtech, HL7, HL7 Interfacing, Medical Business, Medical Technology, Medtech, Modern Healthcare, Patient ExperienceRelieving Medical Billing Frustrations: The Benefits of Outsourcing to Qualified Professionals
Medical billing plays a pivotal yet oft-overlooked role in provider financial stability and continuity of care operations. However, limited resources and inadequate solutions burden in-house teams trying to navigate outdated systems. The resulting claim delays, reimbursement leakage, and patient dissatisfaction has brought many practices to a breaking point. While outsourcing presents risks if not properly […]
billing, healthcare, Healthcare Billing, Medical, Medical Billing, outsourced billing, outsourced medical billing, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, Robotic Process Automation, RPAThe Secret Sauce: Essential Ingredients for Optimized Medical Billing Outcomes
Medical billing sits at the heart of provider revenue cycles, yet few fully appreciate the complexities billing teams navigate to keep financial flows stable. Between interpreting endless payer policies, wrestling with outdated technology, and managing behind-the-scenes patient communications, it takes specialized skills to turn charges into reimbursements. It serves as the financial backbone of the […]
Healthcare Billing, Healthcare Outcomes, Medical, Medical Billing, Medical Billing Ingredients, Medical Billing Service, Outcomes, outsourced billing, outsourced medical billing, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, Robotic Process Automation, RPA, Secret Sauce