A clean claim rate is the share of your claims that get paid on the first submission, with no rejection, no denial, and no request for more information. It is one of the plainest numbers in medical billing, and it tells you more about the health of your revenue cycle than almost any report in […]
Billing Challenges, Billing KPIs, CCR, Clean Claim Rate, Revenue Cycle Management
Billing and claims processing is probably not what got you into the behavioral health field in the first place. You were driven by a passion to help people overcome mental health challenges, develop positive coping strategies, and improve their overall well-being. But as much as we might wish it were different, managing billing is an […]
Behavioral Health Billing, Billing Challenges, Billing Codes, Modifier Codes, Modifiers
New versus established patient billing goes wrong when a patient’s status is misjudged on the front end, which can risk a denial or quietly underpay every claim for a visit that should have coded higher. The distinction between new and established comes down to a specific three-part test, not a front-desk gut check, and the […]
Billing Challenges, Outsourced Billing, Revenue Cycle Management, Revenue Cycle Optimization, Verifying Insurance
Many questions exist in the medical billing and coding industry because it is a detailed and fast-changing field which requires a high level of accuracy and attention to detail. The healthcare industry is dynamic and is subject to frequent changes in laws, regulations, and insurance policies, which can impact the billing and coding process. Additionally, […]
Billing Challenges, Claim Denials, ICD-10, Medical Biller, Medical Coder