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Posts tagged "Medical Claims"

Medical Claims Explained: Payer Types, Claim Forms, Coding Basics, Billing Workflow

November 22, 2023 / Alex J. Lau / Medical Claims
White Female Medical Billing Outsourced

A medical claim is the formal request a healthcare provider submits to an insurance payer asking for reimbursement for services delivered to a covered patient. Every claim contains standardized codes identifying the diagnosis, the procedure performed, and the provider who delivered care, along with patient demographics, insurance information, and the amount billed. The payer reviews […]

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Claim Denials, Claim Rejection, Denial Management, Medical Billing, Medical Claims

Medical Billing Issues Affecting Healthcare Provider Revenue

July 20, 2021 / Alex J. Lau / Medical Billing
Medical billing specialist pointing to billing code data on-screen while consulting with a colleague.

Medical billing issues that cut into provider revenue often start at the front desk. Let’s say a patient comes in and gives you his or her Medicare card. The front desk carefully records the information and billing submits the charge to Medicare. But the claim is rejected, maybe even from the clearinghouse. The problem? The […]

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Diagnostic Code, Healthcare Billing, Medical Billing Service, Medical Claims, Outsourced Billing

Recent Posts

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  • Management Service Organization (MSO) CEO

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  • Provider Credentialing Specialist

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Recent Posts

  • Medical billing specialist wearing a headset reviews a fee schedule and claims spreadsheet at her desk beside ICD-10 coding books in a busy clinic

    Fee Schedule Drift: What Changes When You’re Not Watching

  • Blue Cross Blue Shield (BCBS) Credentialing

    BCBS Credentialing by State: What Changes and What Doesn’t

  • Management Service Organization (MSO) CEO

    Management Services Organizations: What Private Practices Need to Know Before Signing

  • Payer Contracting Scene. A Provider and Payer.

    In-Network vs. Out-of-Network Contracting: Which Pays More for Your Specialty?

  • Provider Credentialing Specialist

    Why You Can’t Bill What You Can’t Credential

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