Billing & Credentialing Cranberry Twp. (Pittsburgh)
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  • Posts tagged "reimbursement"

Posts tagged "reimbursement"

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 […]

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billing, Claim Denial Rate, Claim Denials, compliance, EHR, EMR, Interoperability, Medical Billers, Medical Billing, medical billing questions, Modifiers, reimbursement, Reimbursement Models, Reimbursement Optimization

Maximizing Healthcare Provider Reimbursement

August 9, 2024 / admin / Articles, Charge Capture, Data Analytics, Denial Management, Fee Schedule, Medical Coding, Outsourced Billing, Payer Contract, Payer Contracting, RCM, Reimbursement, Reimbursement Models, Reimbursement Optimization, Value-based Care
Medical Reimbursement

Achieving maximum reimbursement is crucial for healthcare providers to maintain financial stability and continue delivering high-quality patient care. We explore key strategies and best practices that healthcare providers in the United States can implement to optimize their reimbursement processes and maximize revenue. Understanding the Reimbursement Landscape Before diving into specific strategies, it’s essential to understand […]

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Charge Capture, Data Analytics, denial management, Fee Schedule, medical coding, outsourced billing, Payer Contract, Payer Contracting, rcm, reimbursement, Reimbursement Models, Reimbursement Optimization, Value Based Care

Navigating Fee Schedules and Reimbursement Rates

May 12, 2024 / admin / Articles, Fee Schedule, Fee Schedules and Reimbursement Rates, Optimizing Reimbursements, Reimbursement, Reimbursement Model Shift, Reimbursement Models, Reimbursement Optimization, Reimbursement Rates, Reimbursement Regulations
Navigating Fee Schedules and Reimbursement Rates

Few topics get finance teams and medical billing professionals quite as fired up as fee schedules and reimbursement rates. It’s the core of how healthcare providers generate revenue and keep operations humming. At the same time, it’s an arena loaded with complexity, regulatory scrutiny, and often mind-numbing minutiae. If you’re reading this, you’re probably intimately […]

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Fee Schedule, Fee Schedules and Reimbursement Rates, Optimizing Reimbursements, reimbursement, Reimbursement Model Shift, Reimbursement Models, Reimbursement Optimization, reimbursement rates, Reimbursement Regulations

How to Renegotiate Your Payer Contracts

April 15, 2024 / admin / Articles, Data Analytics, Payer Contract, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payer Enrollment, Payer Negotiation, Reimbursement, Reimbursement Models, Reimbursement Rates, Renegotiate Payer Contracts
Renegotiating Payer Contracts

So, it’s that time again. Your payer contracts are up for renewal and you need to renegotiate. Maybe you’re feeling like the reimbursement rates they’re offering are way too low. Or the administrative burdens and preauthorization requirements have gotten out of hand. Whatever the reason, you know you need to go back to the negotiating […]

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Payer Contract, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payer enrollment, Payer Negotiation, reimbursement, Reimbursement Models, reimbursement rates, Renegotiate Payer Contracts

The Challenges and Opportunities of Digital Therapeutics (DTx) Reimbursement

February 19, 2024 / admin / Articles, Digital Health Center of Excellence, DTx, DTx Billing, DTx Reimbursement, Integration, Real-World Evidence, Reimbursement, Reimbursement Disruption, Reimbursement Models, Revenue Cycle, Revenue Cycle Management, RWE
Digital Therapeutics Reimbursement

The healthcare industry is undergoing a digital transformation, with software-based therapeutic interventions known as digital therapeutics emerging as disruptive new modalities to prevent, manage, and treat a growing range of medical conditions. Digital Therapeutics Breakdown Digital therapeutics deliver evidence-based treatments directly to patients through smart devices and applications. These data-driven tools provide personalized interventions, feedback, […]

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Digital Health Center of Excellence, DTx, DTx Billing, DTx Reimbursement, healthcare, Integration, Interoperability, Interoperability and Integration, Medical, Medical Billing, Optimize Reimbursement, Real-World Evidence, reimbursement, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, RWE

The Reimbursement Model Shift in Medical Billing

January 29, 2024 / admin / Accountable Care Organizations, Articles, Billing, Billing Operations, Bundled Payments, Capitation, Fee-for-Service, Fee-for-service Model, Medical Billing, P4P, P4P Model, Pay-for-Performance, Reimbursement Disruption, Reimbursement Models, Value-based Care, Value-Based Models, Value-based Reimbursement
Medical Billing Company Employees

The healthcare industry in the United States has undergone massive changes in recent decades. One of the most significant shifts has been in how healthcare providers get reimbursed for services. The traditional fee-for-service model is giving way to value-based models that tie reimbursement to quality of care and patient outcomes. This transformation in reimbursement is […]

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Accountable Care Organizations, Billing Operations, Bundled Payments, Capitation, Fee-for-Service, fee-for-service model, P4P, P4P Model, Pay-for-Performance, reimbursement, Reimbursement Disruption, Value Based System, Value-Based Models, Value-based Reimbursement

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

How Both Healthcare Providers and Medical Billing Companies Succeed

February 3, 2023 / admin / Articles, Billing Best Practice, Claim Status, Claim Status Updates, Healthcare Provider's Expectations, Medical Billing Best Practices, Medical Billing Expectations, Reimbursement, Reimbursement Regulations
Medical Billing Healthcare Provider Handshake

The Business Relationship Between a Healthcare Provider and Medical Billing Company has to be Built on a Solid Foundation What are the Steps in Achieving a Healthy Business Relationship Between a Healthcare Provider and a Medical Billing Company? A good understanding of both sides’ expectations is crucial to the success of both parties. The healthcare […]

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Claim Status Updates, Customer Service, healthcare, Healthcare Provider's Expectations, healthcare providers, Medical Billing, Medical Billing Customer Service, Medical Billing Expectations, Medical Billing Service, medical billing strategy, medical claims, outsourced billing, reimbursement, Reimbursement Regulations, Revenue Cycle Management

All About ICD-10 Codes

February 1, 2023 / admin / Articles, Billing, Claim Billing, Healthcare, Healthcare Billing, ICD-10, ICD-10 to ICD-11, ICD-9 to ICD-10, Medical, Medical Billing
ICD-10 Codes

What are ICD-10 Codes? ICD-10 codes are the tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD), a medical classification system used worldwide to classify and code diseases and health conditions. The ICD-10 codes are used by healthcare providers and insurance companies to accurately describe and categorize medical diagnoses, treatments, […]

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healthcare, Healthcare Billing, ICD-10, ICD-10 lookup, ICD-11, Medical Billing, reimbursement, WHO, World Health Organization

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Practices Served

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

Practices Served

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

Recent Posts

  • Laboratory Billing

    Which CPT Codes are Used in Laboratory Billing?

  • Medical Credentialing Staff at a Hospital

    25 Stats Medical Credentialers Must Know

  • Older Female Doctor in need of Credentialing

    Credentialing Problems? We Can Fix Them!

  • Medical Credentialing State-by-State

    Multi-State Licensing in Provider Credentialing

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