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Posts tagged "Billing"

G2211 Add-On Code: When to Use It, When Not To, How to Avoid Denials

March 8, 2026 / Alex J. Lau / Add-on Code, Billing, G2211, G2211 Add-on Code, Medical Coding
G2211 Medicare HCPCS add-on code

G2211 is a Medicare add-on code that can be billed alongside office visit E/M codes 99202 through 99215 to capture additional reimbursement for the longitudinal care coordination work providers perform when managing a patient’s single serious condition or a complex, ongoing condition. CMS added the code effective January 1, 2024, with a payment value of […]

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Add-on Code, Billing, G2211, G2211 Add-on Code, Medical Coding

What Is Value-Based Care? How VBC Payment Models Work and What They Mean for Providers

August 23, 2025 / Alex J. Lau / Billing, Value-Based Care, VBC
Value-Based Care Models

Value-based care (VBC) is a healthcare payment model in which providers are reimbursed based on patient health outcomes and cost efficiency rather than the volume of services they deliver. Under traditional fee-for-service payment, a provider is paid a set rate for each procedure or visit regardless of whether the patient’s condition improves. Under value-based arrangements, […]

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Billing, Value Based Care

Healthcare Provider Freedom: Declaring Independence from Administrative Tyranny

July 4, 2025 / Alex J. Lau / Administrative Independence
American Independence; Healthcare Business Freedom

As we celebrate the Fourth of July and reflect on what independence truly means, there’s a powerful parallel between America’s fight for freedom from British rule and the ongoing struggle healthcare providers face today. Just as our founding fathers sought liberation from oppressive taxation and bureaucratic control, modern healthcare professionals are discovering their own path […]

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Administrative Independence, Billing, Credentialing, Independent Healthcare

“Medical Billing Near Me”: Service Across Major U.S. Cities

October 22, 2024 / Alex J. Lau / Billing, Medical Billing, Medical Billing Near Me
Medical Billing Near Me

When healthcare providers search for “medical billing near me,” they’re looking for reliable, professional services that understand their local healthcare landscape. While we’re based just north of Pittsburgh, PA, where we’ve been serving the community for decades, our expertise extends across the United States, providing specialized medical billing and credentialing services to healthcare providers in […]

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Billing, Medical Billing, Medical Billing Near Me

Common Genetic Testing Modifiers

August 20, 2024 / Alex J. Lau / Genetic Testing, Modifiers
Genetic Testing Modifier

As our understanding of genetics and its role in healthcare continues to expand, so does the complexity of billing for these services. One of the key elements in ensuring accurate billing and appropriate reimbursement for genetic testing is the proper use of modifiers. These two-character codes provide additional information about the services rendered, helping to […]

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Billing, Genetic Testing Billing, Genetic Testing Modifiers, Modifiers

Brace for Impact: Managing the Surge of New Medical Billing Regulations

November 27, 2023 / Alex J. Lau / Billing, Billing Regulations, Billing Revenue, Claim Data, Good Faith Estimates, Health Level 7, Healthcare, HL7, Interoperability, Medicaid, Medical Billing Regulations, Medicare, No Surprises Act, Pre-Authorization
Medical Billing Software White Male User

As US healthcare costs continue rising steeply – now over $4 trillion representing nearly 20% of GDP – both federal and state policymakers urgently seek ways to contain runaway expenditure growth. This drive manifests through expansion of programs like Medicare Advantage and Medicaid managed care coupled with accelerating passage of game-changing legislation like No Surprises […]

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Billing, Billing Best Practice, Billing Disruption, Billing Revenue, Claim Data, Consumer-Centered Billing, Good Faith Estimates, Health Level 7, Healthcare, HL7, Interoperability, Medicaid, Medical Billing Regulations, Medicare, No Surprises Act, Pre-Authorization

Which CPT Codes are Used in Urgent Care Billing?

May 28, 2023 / Alex J. Lau / Billing, Billing Codes, E/M Codes, E/M Coding, Healthcare, Healthcare Billing, ICD-10, ICD-10 Coding, Medical Billing, Medical Billing and Coding, Procedural Codes, Procedure Modifiers, Urgent Care CPT Codes, Urgent Care Diagnosis Codes, Urgent Care Modifiers
Urgent Care CPT Codes

Urgent care clinics have become an increasingly popular option for patients seeking prompt medical attention for non-life-threatening conditions. These facilities provide convenient, affordable, and timely care for a wide range of illnesses and injuries that are too severe to wait for a scheduled appointment but not serious enough to warrant a visit to the emergency […]

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Articles, Billing, Billing Codes, E/M codes, E/M coding, Healthcare, Healthcare Billing, ICD-10, ICD-10 coding, Medical Billing, Medical Billing and Coding, Procedural Codes, Procedure Modifiers, Urgent Care Billing, Urgent Care CPT Codes, Urgent Care Diagnosis Codes, Urgent Care Modifiers

What is EOB in Medical Billing?

May 1, 2023 / Alex J. Lau / Billing, EOB, EOBs, Explanation of Benefits, Explanation of Benefits (EOBs), Explanation of Medical Benefits, Healthcare Billing, Medical Billing, OMB, OMBs
What-is-EOB-in-Medical-Billing

An Explanation of Benefits (EOB) plays a crucial role in helping patients understand the costs and coverage associated with their healthcare services. An EOB is a document that provides a detailed breakdown of a medical claim, outlining the services rendered, the amount billed, the insurance coverage, and the patient’s financial responsibility. Let’s delve deeper into […]

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Billing, EOB, EOBs, Explanation of Benefits, Explanation of Benefits (EOBs), Explanation of Medical Benefits, Healthcare, Healthcare Billing, Medical, Medical Billing, OMB, OMBs

How to Choose the Correct CPT Code

April 21, 2023 / Alex J. Lau / Biling Codes, Billing, Billing Codes, CPT, CPT Code, CPT Codes, Healthcare Billing, Medical Billing
CPT Codes Options

As a medical biller or coder, choosing the correct Current Procedural Terminology (CPT) code is crucial for accurate reimbursement. However, with thousands of codes available, it can be overwhelming to find the right one for your services. We offer a free step-by-step guide on how to choose the correct CPT code for your medical billing […]

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Billing, Correct CPT Code, CPT, CPT Billing Codes, CPT Code, CPT Codes, CPT-10, CPT-10 Codes, Healthcare, Healthcare Billing, Medical, Medical Billing

The Future of Medical Billing

March 27, 2023 / Alex J. Lau / AI, Artificial Intelligence, Billing, Billing Services, Healthcare, Healthcare Billing, HIPAA, HIPAA Compliant, Medical, Medical Billing, Medical Billing AI, Telehealth, Telemedicine
Medical Billing, Credentialing Team

As medical technology continues to evolve, so does the way we manage and pay for healthcare. One area in particular that has seen significant changes in recent years is 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 […]

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AI, Artificial Intelligence, Billing, Billing Services, Healthcare, Healthcare Billing, HIPAA, HIPAA Compliant, Medical, Medical Billing, Medical Billing AI, Telehealth, Telemedicine

Which CPT Codes are Used in COVID-19 Billing?

March 5, 2023 / Alex J. Lau / COVID, COVID Test Kits, COVID Testing Billing, COVID-19, COVID-19 Billing, COVID-19 Test Kit Reimbursement, COVID-19 Testing, COVID-19 Testing Billing
CPT Covid-19 Billing

The COVID-19 pandemic has impacted the world significantly, causing widespread illness, death, and economic disruption. The virus, also known as SARS-CoV-2, primarily spreads through respiratory droplets when an infected person talks, coughs, or sneezes. COVID-19 symptoms range from mild to severe and may include fever, cough, fatigue, body aches, loss of taste or smell, and […]

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Billing, Coronavirus, COVID CPT, COVID CPT-10, COVID-19, COVID-19 billing, COVID-19 CPT, COVID-19 testing, COVID-19 Testing Billing, CPT, CPT Codes, CPT-10, Healthcare, Healthcare Billing, Medical Billing, Medical Billing Service

The Gravity of Medical Billing Compliance

February 23, 2023 / Alex J. Lau / Billing, Billing Best Practice, Billing Services, Claim Billing, HIPAA, HIPAA Compliant, Medical, Medical Billing, Medical Billing Best Practices
Medical Billing White Guy

Medical billing compliance refers to the adherence to laws, regulations, and ethical standards that govern the billing process. Billing procedures are complex and involve many stakeholders, including healthcare providers, patients, insurance companies, and government agencies. Compliance with regulations is critical to ensuring that healthcare providers receive reimbursement for services rendered, patients are charged correctly for […]

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AKS, Anti-Kickback Statute, Billing, False Claims Act, FCA, Healthcare Billing, HIPAA, HIPAA Compliant, Medical Billing, Medical Billing Compliance, Medical Billing Regulation, Stark Law, The Health Insurance Portability and Accountability Act (HIPAA)

Struggling with Claim Denials?

December 28, 2022 / Alex J. Lau / Billing, Billing Denied Claims, Claim Billing, Claim Denials, Claim Rejection, Denials Managements, Denied Claims, Denied Medical Claims, Medical Billing, Medical Claim Denials, Medical Claim Rejection, Medical Claims, Medical Payor

Even healthcare providers who deploy safeguards to dodge insurance payment hazards, occasionally find themselves up against a claim denial. Taking care of denied insurance claims can be a frustrating process for healthcare practitioners and their office staff. That’s why it’s vital to utilize a claim denial management strategy to recognize, solve, recover and avoid denied […]

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Billing, Claim Denial, Claim Denials, Claim Rejections, Denial Management, Denied Medical Claim Prevention, Denied Medical Claims, Healthcare, Healthcare Billing, Medical, Medical Billing, Medical Claim Rejections, Medical Claims, Medical Payor, RCM, Revenue Cycle Management

Skilled Nursing Facility Versus Nursing Home

December 18, 2022 / Alex J. Lau / Medical, Medical Billing, Medical Providers, Medicare, Medicare Coverage, Nursing Home, Old Folks Home, Skilled Nursing, Skilled Nursing Billing, Skilled Nursing Facility

What’s the Difference Between a Skilled Nursing Facility and a Nursing Home? On the surface, a skilled nursing facility and a nursing home may appear rather the same. In fact, some care facilities actually function as both, with a distinct floor or section of a building dedicated to each. The difference between a skilled nursing […]

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Billing, Medical Billing, Medical Billing Service, Nursing Billing, Nursing Facility Billing, Nursing Home, Old Folks Home, Skilled Nursing, Skilled Nursing Billing, Skilled Nursing Facility, Skilled Nursing Facility Billing

Why You Should Integrate EHR Systems and Medical Billing

September 23, 2022 / Alex J. Lau / Billing, Billing AI, Billing Automation, Billing Revenue, Billing RPA, EHR, EHR Integration, EMR, EMR Integration, Health Level 7, HL7, Medical Billing, Medical Billing AI, Medical Billing Artificial Intelligence, Medical Billing Automation

EHR Systems + Medical Billing Integration Medical billing and practice management has long been a labor-intensive task for healthcare providers. There’s little doubt, however, that the use of EHR (Electronic Health Records) or sometimes known as EMR (Electronic Medical Records) has considerably slashed these tasks by offering providers a proven method to effectively streamline their […]

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Billing, Billing AI, Billing Automation, Billing Revenue, Billing Service, EHR, EHR (Electronic Health Records), EHR Integration, EHR Interoperability, Electronic Health Records, Electronic Medical Records, EMR, EMR (Electronic Medical Record), Health Level 7, HL7, Interoperability, Interoperability Standards, Medical Billing

What Do Patients Want from Billing?

November 26, 2021 / Alex J. Lau / Billing, Healthcare, Healthcare Billing, Medical Billing
Medical Billing Specialist

Healthcare Patient Billing Expectations Patients believe every aspect of their healthcare experience contributes to their care, including the medical payment and billing process. And a negative payment incident could impact a patient’s overall impression of a healthcare organization, even if the rest of their experience was positive. According to survey results, patient satisfaction ratings fall […]

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Billing, Billing Service, Healthcare, Medical, Medical Bill, Medical Bill Process, Medical Claims, Medical Patients, Medical Payment

Easier Medical Billing and Credentialing

March 24, 2021 / Alex J. Lau / Billing, Credentialing, Medical Billing, Medical Billing Companies, Medical Credentialing
White Male Medical Doctor at Desk

Medical Billing and Credentialing Made Easy “There just has to be an easier way to perform our billing and credentialing.” If you’ve had to perform your own billing and credentialing, you know exactly what we’re talking about.  For any number of healthcare practices, in-house billing and credentialing is an unpleasant, yet necessary, chore. This is […]

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Billing, Credentialing, Medical Billing, Medical Billing Companies, Medical Credentialing

What Makes Mental Health Billing So Difficult?

October 24, 2020 / Alex J. Lau / Behavioral Health, Behavioral Health Billing, Behavioral Health Codes, Behavioral Health Reimbursement, Billing, Billing Outcomes, Medical Billing, Mental Health Billing, Outsourced Billing, Outsourced Medical Billing
Mental Health (Billing), spelled out with scrabble letters

The healthcare industry is vast and complex, even more so for mental health providers. This is especially true when it comes to the mental health billing process. The variety in the types of services, the time, scope and restraints put on mental health treatments make the billing process quite demanding. If a patient visits his […]

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Behavioral Health, Behavioral Health Billing, Behavioral Health Codes, Behavioral Health Reimbursement, Billing, Billing Outcomes, ICD-10, Medical Billing, Medical Coding, Mental Health, Mental Health Billing, Outsource Medical billing, Outsourced Billing, Outsourced Medical Billing

Recent Posts

  • Medical Credentialing Specialist Searching Payers

    Credentialing Onboarding for New Providers: A Practice Manager’s Guide

  • Paye Contracting Requirements by State

    Payer Contracting Requirements by State: What Changes; What Stays the Same

  • AI Scribes Changing Medical Coding and Billing

    AI Scribes are Changing Medical Coding, Reimbursement

  • Net Collection Rate, analyzed by analyst

    What’s a Net Collection Rate in RCM?

  • Modifier 96 versus Modifier 97

    Modifier 96 vs. Modifier 97: What Therapy Billers Need to Know

  • 'Revalidation versus Recredentialing' Neon Sign

    Revalidation vs. Recredentialing: What’s the Difference? (2026 Guide)

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Recent Posts

  • Medical Credentialing Specialist Searching Payers

    Credentialing Onboarding for New Providers: A Practice Manager’s Guide

  • Paye Contracting Requirements by State

    Payer Contracting Requirements by State: What Changes; What Stays the Same

  • AI Scribes Changing Medical Coding and Billing

    AI Scribes are Changing Medical Coding, Reimbursement

  • Net Collection Rate, analyzed by analyst

    What’s a Net Collection Rate in RCM?

  • Modifier 96 versus Modifier 97

    Modifier 96 vs. Modifier 97: What Therapy Billers Need to Know

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