Billing & Credentialing Cranberry Twp. (Pittsburgh)
  • Facebook
  • Instagram
  • Linkedin
  • Twitter
  • YouTube
  • RSS
Call: (412) 219-4789 | Fax: (866) 422-9277
  • Credentialing
  • Payer Contracting
  • Rate Negotiations
  • Medical Billing
  • Specialties
    • Behavioral Health
    • DME
    • Genetic Testing
    • Urgent Care
    • Pharmacogenetic (PGx) Testing
    • Toxicology
    • Substance Abuse
    • Allergy Testing
    • Speech Therapy
    • Skilled Nursing Facilities
    • Oncology
    • Pathology
    • OBGYN
    • Biologics and Specialty Drugs
    • Telestroke and Teleneurology
    • Digital Therapeutics (DTx)
    • Remote Patient Monitoring
    • Remote Therapeutic Monitoring
    • Home Infusion Therapy
    • Sleep Study Labs
    • Physical Therapy (PT)
    • Occupational Therapy
    • COVID-19 Testing
  • Blog
  • Contact
  • Home
  • Posts tagged "Claim Denial Rate"

Posts tagged "Claim Denial Rate"

Tough Questions Providers May Ask Billers

December 1, 2024 / admin / Articles, Billing, Claim Denial Rate, Claim Denials, Compliance, EHR, EMR, Interoperability, Medical Billers, Medical Billing, Medical Billing Questions, Modifiers, Reimbursement, Reimbursement Models, Reimbursement Optimization
Latina Female Medical Provider Owner

The relationship between medical providers and their billing teams has become increasingly crucial to practice success. As reimbursement models grow more complicated and regulatory requirements more stringent, providers often find themselves grappling with challenging questions about their revenue cycle management. We’ll address the most demanding and complex questions that medical providers frequently ask their billing […]

Read More

Billing, Claim Denial Rate, Claim Denials, Compliance, EHR, EMR, Interoperability, Medical Billers, Medical Billing, Medical Billing Questions, Modifiers, Reimbursement, Reimbursement Models, Reimbursement Optimization

Essential Procedures in Medical Claims Billing

October 25, 2024 / admin / Accurate Coding, Articles, Billing, Billing Denied Claims, Charge Entry, Claim Billing, Claim Denial, Claim Denial Rate, Claim Denials, Denial Management, Denied Claims, Fee Schedule Management, Proper Documentation
Medical Billing Company Principal

If you’ve ever wondered why medical billing seems so complicated, you’re not alone. The process of billing medical claims involves numerous critical procedures that must be followed meticulously to ensure proper reimbursement and compliance. Let’s dive into the most important procedures that can make or break the medical billing process. Patient Information Verification One of […]

Read More

Accurate Coding, Administrative Documentation, Articles, Billing, Billing Denied Claims, Charge Entry, Claim Billing, Claim Denial, Claim Denial Rate, Claim Denials, Clinical Documentation, Denial Management, Denied Claims, Fee Schedule Management, Proper Documentation

What is a Clean Claim Rate?

October 12, 2024 / admin / Articles, 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
electronic-claim-attachments

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 […]

Read More

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

Mastering Denial Management: Tactics for Maximizing Reimbursements

March 14, 2024 / admin / Articles, Billing, Claim Denial, Claim Denial Prevention, Continuous Process Improvement, Data Analytics, Denial Analytics, Denial Management, Denial Prevention Strategy, Denial Trends, Denied Claims, Denied Medical Claims, Disrupted Cash Flow, Medical Billing, Revenue Leakage
Denial Management Resource

Denial management has emerged as a critical component for healthcare providers and organizations. As payers become more stringent in their reimbursement policies and regulatory requirements tighten, effective denial management strategies are essential for minimizing revenue leakage and ensuring financial stability. According to industry reports, up to 90% of denied claims are recoverable, representing a significant […]

Read More

Administrative Burden, Billing, Claim Denial Prevention, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Continuous Process Improvement, Denial Analytics, Denial Codes, Denial Management, Denial Prevention Strategy, Denial Trends, Denials Managements, Denied Claims, Denied Medical Claims, Disrupted Cash Flow, Patient Dissatisfaction

Claim Denial vs. Rejection: What’s the Difference?

February 23, 2024 / admin / Articles, Claim Denial, Claim Denial Prevention, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Claims Management, Clearinghouse Rejection, Denial Management, Denial Prevention Strategy, Denial Trends, Denial vs Rejection, Denied Claims, Denied Medical Claims, Payer Rejection, Rejected Claims
Medical Claim Denied Doctor

In the healthcare industry, there are two main ways that insurance companies respond when they decide not to pay a claim – denial and rejection. Both indicate the claim will not be paid, but there are some important differences between the two. Understanding the distinction is critical for medical providers to correctly follow-up so they […]

Read More

Claim Denial, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Clearinghouse Rejection, Denial vs Rejection, Denied Claims, Healthcare, Healthcare Billing, Medical, Medical Billing, Payer Rejection, RCM, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization

Decoding Medical Claims: an Introductory 101 Guide

November 22, 2023 / admin / Articles, Billing, Charge Capture, Claim Billing, Claim Data, Claim Denial Rate, Claim Denials, Claim Rejection, Claim Rejection Rate, Claim Status, Claim Transmission, Claims Management, Coding, First Pass Rate, High Claim Volumes, Patient Dissatisfaction, Provider Dissatisfaction, Regulatory Exposure, Suboptimal Claims
White Female Medical Billing Outsourced

Navigating insurance claims represents one of the most vital yet complex aspects of running a successful medical practice. Claim submission impacts cash flow, revenue realization, and provider satisfaction. For staff new to healthcare administration, the terminology and processes around medical claims can seem confusing. We analyze the fundamentals in simple terms – from types of […]

Read More

Charge Capture, Claim Denial Rate, Claim Rejection Rate, Claim Transmission, Claims Lifecycle Management, Claims Management Challenges, First Pass Rate, High Claim Volumes, Patient Dissatisfaction, Provider Dissatisfaction, Regulatory Exposure, Suboptimal Claims

Recent Posts

  • Florida Medical Billing, Credentialing

    Florida Medical Billing, Credentialing: The Sunshine State’s Standards

  • American Independence; Healthcare Business Freedom

    Healthcare Provider Freedom: Declaring Independence from Administrative Tyranny

  • Healthcare Provider Data Management

    What is Healthcare Provider Data Management?

  • Credentialing Needed Female Medical Doctor

    Medicare Modifiers: a Complete Guide

  • White Male Medical Doctor Holding Stethoscope

    Competency-Based Credentialing in Healthcare

  • White Male Medical Doctor Needs Credentialing

    The Worst Credentialing Problems and How to Solve Them

Practices Served

  • Behavioral Health
  • DME
  • Genetic Testing
  • Urgent Care
  • Pharmacogenetic (PGx) Testing
  • Toxicology
  • Substance Abuse
  • Allergy Testing
  • Speech Therapy
  • Skilled Nursing Facilities
  • Oncology
  • Pathology
  • OBGYN
  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

Practices Served

  • Behavioral Health
  • DME
  • Genetic Testing
  • Urgent Care
  • Pharmacogenetic (PGx) Testing
  • Toxicology
  • Substance Abuse
  • Allergy Testing
  • Speech Therapy
  • Skilled Nursing Facilities
  • Oncology
  • Pathology
  • OBGYN
  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
  • Digital Therapeutics (DTx)
  • Remote Patient Monitoring
  • Remote Therapeutic Monitoring
  • Home Infusion Therapy
  • Sleep Study Labs
  • Physical Therapy (PT)
  • Occupational Therapy
  • COVID-19 Testing

Recent Posts

  • Florida Medical Billing, Credentialing

    Florida Medical Billing, Credentialing: The Sunshine State’s Standards

  • American Independence; Healthcare Business Freedom

    Healthcare Provider Freedom: Declaring Independence from Administrative Tyranny

  • Healthcare Provider Data Management

    What is Healthcare Provider Data Management?

  • Credentialing Needed Female Medical Doctor

    Medicare Modifiers: a Complete Guide

  • White Male Medical Doctor Holding Stethoscope

    Competency-Based Credentialing in Healthcare

  • White Male Medical Doctor Needs Credentialing

    The Worst Credentialing Problems and How to Solve Them

  • Asian Male Doctor in Need of Credentialing

    What are the Main Types of Medical Credentials?

Quick Links

  • About Medwave
  • CAQH ProView Form
  • Regions Served
  • New Practice
  • Specialties
  • Medical Credentialing
  • Recredentialing
  • Payer Contracting
  • Rate Negotiations
  • Medical Billing
  • Denial Management
  • HL7 Integration
  • Robotic Process Automation (RPA)
  • A/R Recovery
  • Telehealth Billing
  • Revenue Cycle Consulting
  • CPT Code Category Index
  • FAQ
  • Pricing
  • Blog
  • Contact

Quick Connect

  • (412) 219-4789
  • Fax: (866) 422-9277
  • Contact Us
    • Linkedin
    • YouTube
    • Facebook
    • Twitter
    • Pinterest
    • Instagram

Medwave @ Goodfirms

Medwave | Alignable

Medwave @ Inc. 5000

© 2025, Medwave Medical Billing, LLC. | Cranberry Township, PA, 16066 | Phone: (412) 219-4789 | Fax: (866) 422-9277 | Sitemap | Privacy Policy