Billing and Coding Partner for Healthcare Medwave is a premier provider of medical billing and coding services. But, exactly why are billing and coding so important and how can Medwave help your healthcare center perform these functions? It’s certainly no surprise that the healthcare business is thriving, and its growth is projected to endure well […]
billing, healthcare, Healthcare Billing, HIPAA, HIPAA Compliant, Medical Billing, medical coding
Billing & Payment Processing for Medical Marijuana Cannabis A Proven Commodity Marijuana Cannabis is projected to be one of the fastest-growing industries over the next decade. Worldwide cannabis sales more than tripled, from $3.4 billion to $10.9 billion between 2014 and 2018, and Wall Street has forecast that sales will grow $30 billion by 2025. […]
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Outsourcing DME (Durable Medical Equipment) Billing In a constantly growing healthcare industry, Durable Medical Equipment (DME) have become an increasingly popular choice of healthcare-related services to millions of patients nationwide. In fact, a recent survey performed on the DME products industry found that the market would grow significantly over the next 10 years. With the rising […]
DME, DME Billing Service, Durable Medical Equipment, Durable Medical Equipment billing, HME, HME Billing Service, Home Medical Equipment, Home Medical Equipment billing
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 Billing
Outsource Your Medical Billing to Avoid Issues Installing a cost-effective, effectual medical billing team is one of the biggest challenges for any healthcare provider. Whether you’re a behavioral health provider, genetic testing lab or a substance abuse facility, it isn’t easy to create, maintain and scale your own internal medical billing team. Below, some of […]
HIPAA Compliant, inhouse billing, Medical Billing, medical coding, medical credentialing, Outsource Medical billing, outsourced billing, Pittsburgh Hospital Billing, Pittsburgh Medical Billing, Pittsburgh Medical Credentialing, substance abuse
What is Medical Billing? Medical billing is the process of submitting and following up on claims with health insurance companies to receive payment for services rendered by a healthcare provider. It involves coding and classification of diseases, procedures, and treatments and submission of claims to insurance companies for reimbursement. The goal of medical billing is […]
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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 billingMedical billing is the process in which medical providers are paid for performing procedures. The procedures are coded using the most current CPT and ICD-10 codes. The codes are then sent to the insurance companies on the proper HCFA 1500 forms for review and payment. It is the responsibility of the medical biller and coder […]
Medical Billing and Credentialing Differences Medical billing and credentialing for medical providers are two different categories in the healthcare world. Before any medical billing can even be completed, the healthcare provider needs to be credentialed with insurance companies in order to be an approved provider of services. Becoming credentialed as an in-network provider dictates the […]
Billing Versus Credentialing, Billing vs Credentialing, CAQH, Coalition for Affordable Quality Healthcare, CPT codes, Cranberry Medical Billing, Cranberry Medical Credentialing, ICD-10, Medical Billing, medical coding, medical credentialing, payor enrollment, physical therapy billing, Pittsburgh Medical Billing, Pittsburgh Medical Coding, Pittsburgh Medical Credentialing, Pittsburgh PT Billing, PT BillingMedical billing and credentialing for medical providers are two different categories in the healthcare world. Before any medical billing can even be completed, the healthcare provider needs to be credentialed with insurance companies in order to be an approved provider of services. Becoming credentialed as an in-network provider dictates the set amount of reimbursement that […]
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 […]
Behavioral health providers face unique challenges when it comes to payer contracting. The landscape has grown increasingly complex, especially as mental health parity laws have evolved and the demand for behavioral health services has surged in recent years. Let’s dive into the intricacies of behavioral health payer contracting and explore what providers need to know […]
Behavioral Health, Behavioral Health Contracting, Behavioral Health Payer Contracting, Behavioral Health Payor Contracting, Contract Negotiation, contracting, Contracting Fee Schedule, Fee Schedule, Fee Schedule Management, Fee-for-Service, Fee-for-Service (FFS), fee-for-service modelRemote Therapeutic Monitoring (RTM) is a digital health solution that enables healthcare providers to monitor non-physiological data related to therapeutic adherence, response, and functional status. Unlike Remote Patient Monitoring (RPM) which focuses on physiological data, RTM tracks metrics such as therapy adherence, medication response, pain levels, respiratory status, and musculoskeletal system status outside of traditional […]
In the healthcare industry, the terms “credentialing” and “privileging” are often used interchangeably, but they actually serve distinct and critical roles. Failing to understand the differences between these two processes can lead to administrative errors, compliance issues, and even patient safety concerns. As healthcare organizations strive to streamline workflows and ensure the highest standards of […]
compliance, Credentialing, Credentialing vs. Privileging, healthcare credentialing, Legal Compliance, medical credentialing, Privileging
🎃 BOO! Did that denied claim just give you a fright? Don’t worry – we’re here to help you turn those scary denials into sweet success. Just like preparing for trick-or-treaters, a little preparation goes a long way in the world of medical billing. Let’s unmask the spooky specters of denied claims and learn how […]
Claim Denial, Claim Denials, Claim Rejection, Denial Analytics, Denial Codes, denial management, Denial Prevention Strategy, Denials, Denials Managements, denied claims, denied medical claims, Halloween
Denials are an unfortunate reality, in the world of insurance claims and medical billing. However, a denial doesn’t have to be the end of the road. With the right approach and effective appeal strategies, it’s possible to turn these denials into approvals and recover rightful reimbursements. We’ll explore the art and science of appeals, providing […]
Denial Codes, denial management, Denial Management Process, Denial Prevention Strategy, Denial Trends, Denial vs Rejection, Denials, denied claims, denied medical claims
Three critical processes play a pivotal role in ensuring the quality, safety, and efficiency of patient care: credentialing, privileging, and enrollment. While these terms are often used interchangeably, they represent distinct yet interconnected procedures that healthcare organizations must navigate to maintain compliance, mitigate risks, and optimize their operations. Understanding the nuances of each process is […]
Credentialing, Credentialing Accuracy, enrollment, healthcare credentialing, medical credentialing, Payer Credentialing, Payer enrollment, Payer Negotiation, Payor Credentialing, Payor Negotiation, Privileging, Provider Enrollment
In healthcare revenue cycle management, few metrics carry as much weight as the Clean Claim Rate (CCR). This crucial key performance indicator (KPI) serves as a fundamental measure of a healthcare organization’s billing efficiency and effectiveness. As healthcare providers face increasing pressure to optimize their revenue cycles while maintaining high-quality patient care, understanding and improving […]
billing, Billing KPIs, CCR, Claim Denial, claim denial prevention, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Clean Claim Rate, Revenue Cycle, Revenue Cycle Management
Provider credentialing is an essential process for healthcare professionals looking to join insurance networks. We discuss the credentialing process with Cigna, one of the leading health insurance providers in the United States. Understanding and successfully navigating this process is crucial for healthcare providers seeking to expand their practice and serve Cigna’s member population. Overview of […]
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Provider credentialing is a critical process in the healthcare industry that ensures medical professionals meet specific standards of education, training, and experience before they can join an insurance network. We inspect the intricacies of credentialing with Aetna, one of the largest health insurance providers in the United States, offering valuable insights for healthcare providers seeking […]
Aetna, Aetna Credentialing, Credentialing, Credentialing AI, Credentialing and Contracting, Credentialing New Providers, credentialing on-boarding, Credentialing with Aetna, healthcare, medical credentialing, Revenue Cycle Management
Current Procedural Terminology (CPT®) codes are the backbone of medical billing in the United States healthcare system. These standardized codes, maintained by the American Medical Association (AMA), serve as a universal medical language for reporting medical, surgical, and diagnostic procedures and services to entities such as insurance companies, accreditation organizations, and government programs. We go […]
Billing Codes, Coding, Coding Accuracy, coding and billing, Coding and Documentation, Coding Errors, Coding Intricacies, CPT, CPT codes, CPT definitions, Current Procedural Terminology
Healthcare providers face the dual challenge of delivering exceptional patient care while effectively managing the financial aspects of their practice. As healthcare costs continue to rise and patients bear an increasing share of these expenses, it’s crucial for providers to implement strategies that balance financial sustainability with the commitment to high-quality care. We inspect the […]
Patient Billing, Patient Care, Patient Collections, Patient Costs, Patient Dissatisfaction, Patient Experience, Patient Financial Responsibility, Patient Medical Billing, Patient Responsibility, patient satisfaction, Patient-Centered Medical Home, Patient-Centric, Patient-Centric Billing Systems, Patient-FriendlyManaging Increasing Patient Out-of-Pocket Costs and Improving Collections The healthcare landscape in the United States has undergone significant changes in recent years, with one of the most notable shifts being the increasing financial burden placed on patients. As insurance companies and employers look to control costs, patients are facing higher deductibles, copayments, and out-of-pocket expenses. […]
Patient Billing, Patient Care, Patient Collections, Patient Costs, Patient Dissatisfaction, Patient Experience, Patient Financial Responsibility, Patient Medical Billing, Patient Responsibility, patient satisfaction, Patient-Centered Medical Home, Patient-Centric, Patient-Centric Billing Systems, Patient-Friendly
Medical billing stands as a crucial link between healthcare providers and payers. At the heart of this process lies a fundamental principle that every medical biller must embrace: the paramount importance of accuracy in coding. We delve deep into why coding accuracy is not just a best practice, but an absolute necessity in medical billing, […]
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Medical billers play a crucial role in ensuring that healthcare providers receive proper compensation for their services. If you’re interested in a career that combines healthcare knowledge with financial acumen, becoming a medical biller might be the perfect path for you. We’ll guide you through the process of entering this rewarding field, from understanding the […]
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