Revenue cycle management (RCM) is a critical component of running a successful and financially stable medical practice. However, with the complexity of medical billing and constantly changing payer rules, many healthcare providers struggle to manage their revenue cycle effectively. This results in lost revenue due to suboptimal reimbursement rates, denial rates, collection rates, and other […]
billing, healthcare, Healthcare Billing, Medical, Medical Billing, rcm, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Management Consulting, revenue cycle optimization, Revenue Leakage, Robotic Process Automation
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 optimization
At first glance, medical billing and professional sports seem to occupy opposite ends of the career spectrum. However, there are interesting parallels in how these two worlds operate when it comes to finances, data, and competition. Drawing comparisons between the healthcare administration and athletics provides unique insights that billing professionals can apply to enhance their […]
AI, artificial intelligence, Claim Data, Data, healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Service, outsourced billing, outsourced medical billing, rcm, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, sports, sports vs billing
The healthcare industry is facing a critical staffing shortage that is impacting medical billing operations and revenue cycle management. With an aging population and expanded access to healthcare, the demand for healthcare services is rising. However, there is a shortage of healthcare workers, including medical billers and coders, to meet this growing demand. This is […]
billing, Billing Staff, COVID billing, COVID-19, healthcare, Healthcare Billing, Medical Billing Staff, medical coding, Outsource Billing, Outsource Medical billing, outsourced billing, outsourced medical billing, rcm, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, Robotic Process Automation
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 medical practices and hospitals. One […]
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 optimization
Cases of a new COVID-19 variant, temporarily designated JN.1, are rising rapidly nationwide. According to data from the U.S. Centers for Disease Control and Prevention, JN.1 now accounts for 44% of all COVID-19 infections in the country. That represents more than double its share compared to just a week prior, highlighting the dramatic growth rate […]
COVID billing, COVID Testing, COVID testing billing, COVID-19, COVID-19 testing, healthcare, Healthcare Billing, JN.1, Medical, Medical Billing, outsourced billing, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization
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, RPA
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
Robotic Process Automation (RPA) has transformed industries across the globe by automating repetitive, rules-based digital tasks. In recent years, healthcare providers have begun to realize the immense potential benefits RPA can offer their organizations too. Implementing RPA can be a challenging process, but for those willing to invest in change, the payouts are plentiful. Below, […]
AI, artificial intelligence, Automation, Billing Automation, healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Automation, Revenue Cycle Management, revenue cycle optimization, Robotic Process Automation, RPA
With nearly 30 million residents, Texas maintains the second largest state population in the country. This burgeoning community includes diverse urban metropolises like Dallas, Houston, San Antonio and Austin as well as remote rural towns and border communities. The variability in patient demographics and healthcare access models across Texas locations generates pronounced impacts on medical […]
Austin Medical Billing, Dallas Medical Billing, healthcare, Healthcare Billing, Houston Medical Billing, Medical, Medical Billing, Medical Billing Service, outsourced billing, outsourced medical billing, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, San Antonio Medical Billing, Texas Care Delivery, Texas Medical Billing
With over 21 million residents, Florida maintains one of the largest and most demographically diverse state populations across the country. This presents unique dynamics around healthcare delivery and insurance for which medical billing service providers must adapt. From an aging population to an influx of northern transplants, to the millions relying on government insurance plans […]
Billing Services Florida, Florida Billing, Florida Billing Services, Florida Medical Billing, healthcare, Healthcare Billing, Medicaid HMO, Medical, Medical Billing, Medical Billing Service, Medicare Advantage, Miami Medical Billing, Orlando Medical Billing, Revenue Cycle Management, revenue cycle optimization, Tampa Medical Billing
Medical billing involves the complex processes of coding services, generating insurance claims, managing rejection disputes, and ultimately securing optimal reimbursement for healthcare providers. With mounting administrative burdens and revenue pressures facing US healthcare systems, demand has accelerated for skilled medical billing talent. However, tight labor markets have spurred shortages. Below, we analyze the spreading adoption […]
healthcare, Healthcare Billing, HIPAA, HIPAA Compliant, HL7, Medical, Medical Billing, Offshore Billing, Outsource Medical billing, outsourced billing, outsourced medical billing, rcm, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, Robotic Process Automation, RPA
As healthcare payers implement more rigorous utilization management programs, denial rates on medical claims have been steadily climbing – up to nearly 10-15% on average for practices based on reports. Denials directly impact revenues and practice bottom lines due to the costs of reworking and appealing claims. We offer an overview of building a denial […]
Claim Denials, Denial Codes, denial management, Denial Prevention Strategy, Denial Trends, denied medical claims, healthcare, Healthcare Billing, Medical Billing, Medical Billing Service, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization
The COVID-19 pandemic triggered an explosion in telehealth utilization across healthcare. While telehealth billing processes matured during the public health emergency, new complexities are emerging as virtual care delivery models expand. Practices must stay updated on billing and coding guidelines for telemedicine services spanning video visits, remote patient monitoring, mental health apps, and more. We […]
(POS) Codes, Chronic care management, Digital Therapeutics, healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Service, rcm, Remote Patient Monitoring, Remote Patient Monitoring (RPM), Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, RPM for Clinical Trials, telehealth, Telehealth Billing, telehealth delivery, telehealth experience, Telemedicine, Wearable Integration
For any medical practice, timely insurance reimbursement is essential for financial viability and supporting smooth practice operations. However, elongated claim payment cycles strain cash flow and necessitate borrowing to cover costs in the interim. Below, we explore techniques to accelerate payer payments and optimize the speed of the medical revenue cycle. Diagnosing Causes of Lagging […]
Cash Flow Cycles, healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Service, medical billing strategy, rcm, reimbursement, reimbursement rates, Revenue Cycle, Revenue Cycle Management, revenue cycle optimizationMedical billing is a core function that impacts practice revenues, costs, and efficiency. A key decision practices face is whether to handle billing internally or choose an outsourced billing service. What are the relative benefits and drawbacks of each model? We examine the pros and cons of in-house vs outsourced billing to help practices select […]
billing, billing services, Claim Billing, healthcare, Healthcare Billing, In-House Billing, Medical, Medical Billing, Medical Billing Cost, outsourced medical billing
For medical practices, claim denials have always been a fact of life when dealing with health insurers. However, trends show claim denial rates growing year over year, driven by increased utilization management efforts by payers. Denials directly impact practice revenues and the time/costs tied to appealing denials. Below, we take a gander at the factors […]
Claim Denials, Denial Codes, Denial Prevention Strategy, Denial Trends, Denials, denied medical claims, healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Service, Revenue Cycle Management, revenue cycle optimizationFor modern healthcare practices, efficient and accurate medical billing operations are essential to financial success. However, manual billing processes can be time-consuming, error-prone, and make it difficult to scale. Automating key steps in the medical billing workflow brings game-changing improvements in productivity, reduction of costly claim errors, accelerated revenue cycles, and optimized billing costs. Benefits […]
AI, healthcare, Healthcare Billing, Intelligent automation, Manual Billing Workflow, Medical, Medical Billing, Medical Billing Automation, Medical Billing Robotic Process Automation, Medical Billing Service, Revenue Cycle Management, revenue cycle optimization, Robotic Process Automation, Robotic Process Automation Billing, RPA
Selecting the right medical billing software is crucial for modern healthcare practices looking to optimize their revenue cycle. However, with hundreds of solutions on the market, all touting advanced features, it can get overwhelming for practices to figure out the best fit. Must-Have Medical Billing Software Features While each practice has unique requirements, some core […]
Billing Data, Billing Software, Billing Software RPA, healthcare, Healthcare Billing, HL7, HL7 Standards, Medical Billing, Medical Billing Integration, Medical Billing Platform, Medical Billing RPA, medical billing software, Robotic Process Automation, RPA, RPA HL7
Medical billing is a complex, numbers-driven process. To elevate revenues and efficiency, healthcare practices must constantly measure, analyze and optimize their medical billing and revenue cycle performance using key metrics. The Importance of Analytics in Medical Billing In the dynamic healthcare landscape, data is king. Medical practices that succeed at leveraging data make better decisions […]
CPT Code, healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Analytics, Medical Billing Service, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, Robotic Process Automation
ICD-10 Codes ICD-10 codes are a set of alphanumeric medical diagnosis and procedure codes used for medical billing and clinical documentation. Maintained by the World Health Organization, ICD-10 contains about 69,000 codes compared to 13,000 in the older ICD-9 version. The codes provide specificity around body location, severity, comorbidities, and episode of care. Implementation of […]
CPT-10, healthcare, Healthcare Billing, ICD-10, ICD-10 Code Changes, ICD-10 coding, ICD-10 Update, Medical, Medical Billing, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization
For any medical practice, keeping accounts receivable cycles short and patient collections high is critical for unlocking the path to financial health. When reimbursement lags become excessive or collection rates decline, financial pressures mount quickly. Covering key strategies and best practices to shorten accounts receivable days, boost patient payments, and strengthen the financial fitness of […]
A/R, A/R Process, A/R Recovery, Accounts Receivable, Accounts Receivable Recovery, AR, healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Service, medical billing strategy, Revenue Cycle Management, revenue cycle optimization
Medical billers and coders play a critical role in the healthcare revenue cycle. Their work processing medical claims ensures providers receive accurate reimbursement for services rendered. But what can these professionals expect to earn as their billing and coding career progresses? We explore key factors influencing medical billing and coding salaries, average pay ranges, top […]
billing, healthcare, Healthcare Billing, Medical, Medical Biller, Medical Billing, Medical Billing and Coding Salaries, Medical Billing Salary, Medical Coder, Medical Coding Salary
Verifying a patient’s insurance eligibility and benefits is a critical first step in the medical billing process. Doing it thoroughly and accurately helps prevent claim denials and delays in payment down the road. We reveal proven techniques to verify eligibility and benefits like a seasoned medical billing pro. Insurance Eligibility Verifying insurance eligibility is crucial in […]
Benefits Verification, Eligibility, healthcare, Healthcare Billing, Insurance Eligibility, Medical Billing, Medical Billing Service, medical billing strategy, Outsource Billing, Outsource Medical billing, outsourced billing, outsourced medical billing, Outsourced Verification, Revenue Cycle Management, revenue cycle optimization, Smarter Verification, Verify Eligibility, Verify Insurance Eligibility
How do you know your medical billing operation is performing optimally? Key performance indicators (KPIs) and metrics provide the critical insights. By regularly tracking the right quantitative measures, you gain visibility into what’s working, uncover issues early, and identify areas for improvement. We reveal essential medical billing KPIs and metrics every practice should monitor. Why […]
healthcare, Healthcare Billing, Healthcare KPIs, KPI, KPIs, Medical, Medical Billing, Medical Billing KPIs, Medical Billing Service, Medical KPIs, Revenue Cycle Management