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  • Posts tagged "Medical Billing" (Page 3)

Posts tagged "Medical Billing"

Billing Workers’ Compensation: A Guide to Making Claims Through HR

February 12, 2024 / admin / Articles, Billing, Billing Best Practice, Denial Management, Denied Claims, HR, Human Resources, Insurance Adjusters, Lost Wages, Workers' Compensation Billing Process, Workers’ Comp Claim, Workers’ Compensation, Workers’ Compensation Billing
Workers' Compensation Billing

Workers’ compensation provides benefits to employees who suffer job-related injuries or illnesses. It covers medical treatment, lost wages, and rehabilitation services. Workers’ comp is regulated at the state level and all businesses are required to have workers’ comp insurance. When an employee is injured on the job, they need to file a claim with their […]

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Healthcare, Healthcare Billing, HR, Human Resources, Insurance Adjusters, Lost Wages, Medical, Medical Billing, Revenue Cycle, Revenue Cycle Management, Workers' Comp, Workers' Compensation, Workers' Compensation Billing Process, Workers’ Comp Claim, Workers’ Compensation Billing, Workmans Comp

Manual Medical Billing is Dead, RPA is the Answer

February 11, 2024 / admin / Articles, Automated Billing, Automation, Billing Analytics, Billing Automation, Manual Billing, RCM, Reimbursement, Revenue Cycle, Revenue Cycle Management, Robotic Process Automation, RPA, RPA Adoption, RPA HL7
robotic-process-automation-RPA-example-code

Medical billing has long relied on manual data entry and paperwork to process claims. But this antiquated approach is no longer sustainable in today’s digital healthcare environment. The future of medical billing lies with robotic process automation (RPA). RPA automates repetitive data entry and workflow tasks, increasing efficiency, reducing human error, and allowing medical billers […]

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Billing Analytics, Billing Automation, Healthcare, Healthcare Billing, Manual Billing, Medical, Medical Billing, Medical Billing Robotic Process Automation, RCM, Revenue Cycle, Revenue Cycle Management, Robotic Process Automation, RPA, RPA Adoption

What are and When to Use Modifier Codes

February 10, 2024 / admin / Anatomic Modifiers, Articles, Bilateral Surgery Modifiers, CMS, Coding, CPT, CPT Codes, CPT Definitions, Global Surgery Modifiers, HCPCS Codes, Medical, Medical Billing, Medical Coding, Missing Modifiers, Modifier Codes, Modifiers, Procedure Modifiers
Medical Billing White Guy

Modifier codes are an important part of medical billing and coding. They provide additional information about a medical procedure or service to help ensure proper reimbursement. Knowing when to use modifier codes can improve claim accuracy and prevent costly payment delays or denials. We explain what modifier codes are, why they are used, the most […]

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Anatomic Modifiers, Bilateral Surgery Modifiers, Billing, Coding, Coding and Billing, CPT, CPT definitions, CPT-10, Global Surgery Modifiers, HCPCS, Healthcare, Healthcare Billing, Medical, Medical Billing, Medical Coding, Medical Necessity, NCCI, NCCI Edits, Payer Policies, Procedure Modifiers, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization

What’s the Difference Between Comprehensive, Component, and Modifier Codes?

February 9, 2024 / admin / Articles, Billing, Bundled Payments, Bundling, Component Codes, Comprehensive Codes, CPT Manual, Healthcare, Healthcare Billing, Medical, Medical Billing, Modifier Code, Modifiers, Unbundling
Medical CPT Codes

Medical billing and coding is an intricate process that requires the use of different types of codes to accurately document procedures, services, diagnoses, and supplies. Three important types of codes are comprehensive codes, component codes, and modifier codes. Understanding the differences between these code types is crucial for accurate medical billing and reimbursement. Comprehensive Codes […]

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-AS, -AT, -CG, -LT, -RT, Adjunct Services, ancillary services, Billing, Bundling, Care Settings, Component Codes, Comprehensive Codes, CPT Manual, Healthcare, Healthcare Billing, Laterality, Medical, Medical Billing, Modifier Codes, Modifiers, Patient Conditions, RCM, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization, Unbundling, Unusual Circumstances

The Essential Guide to Medical Billing Automation

January 31, 2024 / admin / AI, Articles, Artificial Intelligence, Automated Billing, Automation, Billing, Billing Automation, Cloud-based Automation, Healthcare Billing, Medical Billing, Medical Billing Automation
Medical Billing versus Sports

Medical practices are constantly looking for ways to improve efficiency and increase revenue. Yet many practices are still relying on manual, paper-based billing processes that are tedious, error-prone, and time-consuming. In today’s digital age, automated medical billing is a must for any practice that wants to streamline operations, get paid faster, reduce denied claims, and […]

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AI, Artificial Intelligence, Automated Billing, Automating Billing, Billing, Billing Automation, Cloud-based automation, EHR, Healthcare Billing, Medical, Medical Billing, Medical Billing Automation, RCM, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization, Robotic Process Automation, RPA

10 Trends Set to Transform Medical Billing

January 28, 2024 / admin / Analytics, Articles, Changing Regulations, Cybersecurity, Medical Billing, Medical Billing Trends, Outsourcing, Patient Consumerism, Payment Models, Revenue Cycle Management, Robotic Process Automation, RPA, Virtual Care

The healthcare industry is rapidly evolving, driven by advances in technology, changes in regulations, and shifts in consumer behavior. For medical billing professionals, these changes bring both opportunities and challenges. Staying up-to-date on the latest trends is key to remaining competitive and providing the best possible service to healthcare providers. We’ll explore the top 10 […]

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Artificial Intelligence, Big Data, Billing RPA, Changing Regulations, Cybersecurity, Healthcare, Medical Analytics, Medical Billing, Medical Billing Analytics, Medical Billing Trends, Patient Consumerism, Payment Models, Revenue Cycle Management, Revenue Cycle Optimization, Robotic Process Automation, RPA, Telehealth, Virtual Care

How to Take Your Medical Billing to the Next Level in 2024

January 27, 2024 / admin / Articles, Billing, Billing AI, Billing Automation, Billing Best Practice, Billing Revenue, Billing Services, Claims Management, Coding, Denial Codes, Denial Management, Denial Trends, Denied Claims, Healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing AI, Medical Billing Analytics, ROI

Medical billing is a complex and ever-evolving field. With constant changes in regulations, coding guidelines, reimbursement rates, and technology, medical billing services must continuously adapt and improve to stay competitive. Taking your medical billing to the next level requires focusing on efficiency, optimization, training, and utilizing the latest tools and software. Implementing the strategies outlined […]

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Clearinghouse, EDI, Healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Strategy, RCM, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization, Robotic Process Automation, ROI, RPA

Revenue Cycle Management Consulting: Maximizing Medical Revenue Capture

January 26, 2024 / admin / Articles, Revenue, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Management (RCM), Revenue Cycle Management Challenges, Revenue Cycle Management Consulting, Revenue Integrity, Revenue Leakage
Revenue Cycle Management Coins

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 […]

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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

How to Connect an EHR to a Clearinghouse: A Step-by-Step Guide

January 23, 2024 / admin / Articles, Clearinghouse, EHR, EHR API, EHR Integration, EHRs, Electronic Claims, EMR, EMR Integration, Health Level 7, Healthcare, HL7, HL7 FHIR, HL7 messaging, HL7 Standard, Interoperability, Medical, Medical Billing, Medical Billing AI

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 […]

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Clearinghouse, EHR, EMR, Healthcare, Healthcare Billing, HL7, HL7 interface, HL7 interoperability, HL7 messaging, HL7 Standards, Medical, Medical Billing, Revenue Cycle Management, Revenue Cycle Optimization

Medical Billing versus the Sports World: An Unlikely Comparison

January 21, 2024 / admin / Articles, Artificial Intelligence, Billing, Billing Revenue, Billing Services, Claim Billing, Data Management, Healthcare, Healthcare Billing, Medical Billing, RCM, Revenue Cycle, Revenue Cycle Management, Sports
Medical Billing versus Sports

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 […]

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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

Which CPT Codes are Used in Speech Therapy Billing?

January 19, 2024 / admin / Articles, Billing, Billing Automation, Billing Best Practice, Claim Billing, CPT, CPT Codes, Current Procedural Terminology, Revenue Cycle, Revenue Cycle Management, Speech Therapy, Speech Therapy Billing
Speech Therapy CPT Codes

Speech-language pathology services are critical for evaluating and treating communication disorders, swallowing difficulties, and cognitive-linguistic impairments. However, selecting the proper CPT codes for speech therapy can be complex given the many types of assessments, modalities, and interventions provided. We examine the most frequently used Current Procedural Terminology (CPT) codes that speech therapists report to receive […]

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Billing, Common Procedural Terminology (CPT) codes, CPT, CPT codes, Current Procedural Terminology, Medical Billing, Speech Billing, Speech Therapy Billing

Speeding Payment Through Strategic, Outsourced Billing

January 11, 2024 / admin / Articles, Billing, Billing Automation, Medical, Medical Billing, Medical Billing Outsourcing, Medical Billing Service, Medical Claims, Outcomes, Outsource Medical Billing, Outsourced Billing, Outsourced Medical Billing, Outsourcing Medical Billing, Revenue Cycle, Revenue Cycle Management
White Female Revenue Cycle Management

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 […]

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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

Medical Providers and the Untapped Potential of HL7

January 9, 2024 / admin / Articles, Billing, Billing Automation, Billing RPA, Billing Software, EHR, EHR Integration, EMR, EMR Integration, Health Level 7, Healthcare, HL7, HL7 FHIR, HL7 Format, HL7 Interface, HL7 messaging, HL7 Standard, HL7-enabled, Interoperability, Medical, Medical Billing

The healthcare industry has undergone massive changes in recent years, fueled by advances in technology and a shift towards patient-centered care. However, one area that still has untapped potential is the use of Health Level 7 (HL7) standards. HL7 provides a framework for exchanging clinical and administrative data between software applications used by various healthcare […]

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Billing, EHR, EHR Integration, EMR, EMR Interoperability, Health Level 7, Healthcare HL7, HL7, HL7 adoption, HL7 FHIR, HL7 interface, HL7 interoperability, HL7 messaging, HL7 Standard, HL7 v2.x, HL7 v3.0, HL7-enabled, Medical Billing

JN.1 Variant: Navigating COVID-19 Testing Billing Requirements and Optimization

December 29, 2023 / admin / Articles, Billing, COVID, COVID Testing Billing, COVID-19, COVID-19 Billing, COVID-19 Testing Billing, Healthcare Billing, JN.1, Medical Billing
CPT Covid-19 Billing

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 […]

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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

Relieving Medical Billing Frustrations: The Benefits of Outsourcing to Qualified Professionals

December 28, 2023 / admin / Articles, Billing, Billing AI, Billing Automation, Billing RPA, Claim Billing, Claim Denials, Claims Management, Denial Management, Denied Claims, Healthcare, Healthcare Billing, Medical Billing, Medical Billing AI, RCM, Revenue Cycle, Revenue Cycle Management
Outsourcing Medical Billing

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 […]

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Billing, Healthcare, Healthcare Billing, Medical, Medical Billing, Outsourced Billing, Outsourced Medical Billing, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization, Robotic Process Automation, RPA

The Secret Sauce: Essential Ingredients for Optimized Medical Billing Outcomes

December 27, 2023 / admin / Articles, Biling Codes, Billing, Billing AI, Billing Automation, Billing Best Practice, Healthcare Billing, HIPAA, Medical Billing, Medical Billing Ingredients, RCM, Reimbursement, Revenue Cycle Management, Robotic Process Automation, RPA, Secret Sauce
Secret Sauce of Medical Billing

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 […]

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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

Why Would a Medical Provider Want to Use Robotic Process Automation?

December 13, 2023 / admin / Articles, Artificial Intelligence, Automation, Billing, Billing AI, Billing Automation, Claim Transmission, Claims Management, Healthcare, Healthcare AI, Healthcare Billing, HIPAA, HL7, Medical Billing, Medical Billing Automation, Robotic Process Automation, RPA
Robotic Process Automation (RPA) Medical Billing

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, […]

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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

Decoding Medical Billing in Texas (The Lone Star State)

December 9, 2023 / admin / Articles, Billing, Billing Revenue, Healthcare, Healthcare Billing, Medicaid, Medical, Medical Billing, Medicare, Texas Medical Billing
Texas Medical Billing

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 […]

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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

Navigating the Complexities of Medical Billing Services in Florida

December 3, 2023 / admin / Articles, Florida Medical Billing, Healthcare, HIPAA Compliant, HL7, Medicaid, Medicaid HMO, Medical, Medical Billing, Medical Billing Service, Medicare Advantage, Miami Medical Billing, Orlando Medical Billing, Tampa Medical Billing
Florida 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 […]

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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

Evolving Medical Billing Talent Strategies: The Rise of Offshoring and Outsourced Models

November 25, 2023 / admin / Articles, Billing, Billing Automation, Billing Best Practice, Billing Revenue, Billing RPA, Billing Services, Claim Data, Claims Management, Healthcare, Healthcare Billing, HIPAA, HIPAA and Data Protection, HIPAA Compliant, HL7, Medical Billing, Offshore Billing, Outsourced Billing
Offshore 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 […]

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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

Navigating the Rise in Denials: Strategies for Successful Denial Management in Medical Billing

November 17, 2023 / admin / Articles, Data Management, Denial Codes, Denial Management, Denial Prevention Strategy, Denial Trends, Denied Claims, Denied Medical Claims
Rejected, Denied Medical Claim

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 […]

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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

Telehealth Billing Gets More Complex as Virtual Care Services Expand

November 5, 2023 / admin / Articles, Billing, Digital Therapeutics, Healthcare Billing, Medical Billing, Remote Patient Monitoring, Remote Patient Monitoring (RPM), RPM for Clinical Trials, Telehealth, Telehealth Billing, Telemedicine, Wearable Integration
Medical Billing Telehealth Telemedicine

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 […]

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(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

Getting Paid Faster: Strategies to Improve Cash Flow Cycles

October 16, 2023 / admin / Articles, Billing, Cash Flow Cycles, RCM, RCM Challenges, Reimbursement, Reimbursement Rates, Reimbursement Regulations, Revenue, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Management (RCM), Revenue Cycle Management Challenges
Billing Cash Flow Cycles

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 […]

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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 Optimization

Outsourcing vs In-House Billing: Pros and Cons for Practices

October 6, 2023 / admin / Articles, Billing, Billing Services, Claim Billing, Healthcare, Healthcare Billing, In-House Billing, Medical, Medical Billing, Medical Billing Cost, Outsourced Medical Billing
White Female Revenue Cycle Management

Medical 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 […]

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Billing, Billing Services, Claim Billing, Healthcare, Healthcare Billing, In-House Billing, Medical, Medical Billing, Medical Billing Cost, Outsourced Medical Billing

Growing Risk of Claim Denials: How to Protect Your Practice

October 6, 2023 / admin / Articles, Billing, Billing Denied Claims, Claim Denials, Claim Rejection, Claim Status, Claim Status Updates, Denial Codes, Denial Management, Denial Prevention Strategy, Denial Trends, Denied Claims, Denied Medical Claims, RCM, RCM Challenges, Revenue, Revenue Cycle Management, Revenue Integrity, Revenue Leakage
Medical Claim Denied

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 […]

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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 Optimization
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Practices Served

  • Behavioral Health
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  • Speech Therapy
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  • Biologics and Specialty Drugs
  • Telestroke and Teleneurology
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  • Sleep Study Labs
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