Billing & Credentialing Cranberry Twp. (Pittsburgh)
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Call: (412) 219-4789 | Fax: (866) 422-9277
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    • Behavioral Health
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    • Remote Therapeutic Monitoring
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  • Posts tagged "Revenue Cycle Management"

Posts tagged "Revenue Cycle Management"

How to Set Clear Goals for Medical Billing That Keep Your Practice Profitable

November 2, 2024 / admin / Articles, Billing, Billing Goals, Clean Claim Rate, Medical Billing, Medical Billing Goals, RCM, RCM Optimization, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization
Crazy Medical Coder Biller

Let’s face it – medical billing isn’t exactly the most exciting part of running a healthcare practice. But here’s the thing: those numbers directly impact whether your practice thrives or struggles. Having worked with countless medical practices over the years, I’ve seen firsthand how setting clear, strategic billing goals can transform a practice’s financial health. […]

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billing, Billing Goals, Clean Claim Rate, Medical Billing, Medical Billing Goals, rcm, RCM Optimization, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization

Surgery Center Billing: A Modern Guide to ASC Revenue Cycle Management

October 23, 2024 / admin / Ambulatory Surgery Center (ASC) Billing, Articles, ASC, ASC Billing, ASC RCM, ASC Revenue Cycle Management, Revenue Cycle Management, Revenue Cycle Management (RCM), Surgery Billing, Surgery Center Billing
ASC Surgery Billing

Ambulatory Surgery Center (ASC) billing is a complex and nuanced process that requires detailed understanding of multiple healthcare regulations, coding systems, and reimbursement methodologies. As outpatient procedures continue to grow in popularity and complexity, efficient and accurate billing practices have become crucial for the financial success of surgery centers. We explores the key aspects of […]

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Ambulatory Surgery Center (ASC) Billing, Articles, ASC, ASC Billing, ASC RCM, ASC Revenue Cycle Management, billing, Medical Billing, Revenue Cycle Management, Revenue Cycle Management (RCM), Surgery Billing, Surgery Center Billing

“Medical Billing Near Me”: Service Across Major U.S. Cities

October 22, 2024 / admin / Articles, Billing, Billing Locations, Billing Regions, Credentialing, Medical Billing, Medical Billing Near Me, Medical Billing Service, Medical Credentialing, Revenue Cycle Management
Medical Billing Near Me

When healthcare providers search for “medical billing near me,” they’re looking for reliable, professional services that understand their local healthcare landscape. While we’re based just north of Pittsburgh, PA, where we’ve been serving the community for decades, our expertise extends across the United States, providing specialized medical billing and credentialing services to healthcare providers in […]

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billing, Billing Automation, Billing Best Practice, Billing Case Studies, Billing KPIs, Billing Locations, Billing Process, Credentialing, Medical Billing, Medical Billing AI, Medical Billing Near Me, medical credentialing, Revenue Cycle Management

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 […]

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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

A Guide to Provider Credentialing with Cigna

October 11, 2024 / admin / Articles, Cigna, Cigna Credentialing, Credentialing, Credentialing Accuracy, Credentialing with Cigna, Medical Credentialing, Medical Recredentialing, Provider Recredentialing, Recredentialing
Guide to Provider Credentialing with Cigna

Provider credentialing is an essential process for healthcare professionals looking to join insurance networks. We discuss the credentialing process with Cigna, one of the leading health insurance providers in the United States. Understanding and successfully navigating this process is crucial for healthcare providers seeking to expand their practice and serve Cigna’s member population. Overview of […]

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Cigna, Cigna Credentialing, Credentialing, Credentialing AI, Credentialing and Contracting, Credentialing New Providers, credentialing on-boarding, Credentialing with Cigna, healthcare, medical credentialing, Revenue Cycle Management

A Guide to Provider Credentialing with Aetna

October 10, 2024 / admin / Aetna, Aetna Credentialing, Articles, Credentialing, Credentialing AI, Credentialing and Contracting, Credentialing New Providers, Credentialing On-Boarding, Credentialing with Aetna, Medical Credentialing, Recredentialing
Guide to Provider Credentialing with Aetna

Provider credentialing is a critical process in the healthcare industry that ensures medical professionals meet specific standards of education, training, and experience before they can join an insurance network. We inspect the intricacies of credentialing with Aetna, one of the largest health insurance providers in the United States, offering valuable insights for healthcare providers seeking […]

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Aetna, Aetna Credentialing, Credentialing, Credentialing AI, Credentialing and Contracting, Credentialing New Providers, credentialing on-boarding, Credentialing with Aetna, healthcare, medical credentialing, Revenue Cycle Management

Are Medical Billing Codes Universal?

October 8, 2024 / admin / Artificial Intelligence, Billing Codes, Billing KPIs, Billing Outcomes, Blockchain, ICD, ICD Codes, ICD-10, ICD-10 to ICD-11, ICD-11, IHTSDO, Non-Universality Coding, SNOMED CT
Female Medical Coder

Medical billing codes are the backbone of healthcare administration worldwide, serving as a standardized way to communicate diagnoses, procedures, and treatments between healthcare providers, insurers, and government agencies. However, the question of whether these codes are truly universal is complex and multifaceted. We dissect the various medical coding systems used globally, their similarities and differences, […]

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billing, CPT, CPT codes, EHR, EMR, Healthcare Billing, ICD-10, ICD-10 coding, ICD-11, IHTSDO, Medical Billing, Non-Universality Coding, outsourced billing, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, Robotic Process Automation, RPA, SNOMED CT, Systematized Nomenclature of Medicine, Value Based Care

Where Should Providers Focus their Billing Resources?

October 7, 2024 / admin / Articles, Medical Billing, Medical Billing AI, Patient Experience, Patient Registration, Patient Responsibility, Practice Management, Prior Authorization, RCM, Revenue Cycle Automation, Robotic Process Automation, RPA
Medical Billing Resources

Effective medical billing is crucial for the financial health and sustainability of healthcare providers. With limited resources and increasing administrative burden, providers must strategically allocate their billing resources to maximize revenue while maintaining compliance and patient satisfaction. This analysis explores key areas where healthcare providers should focus their medical billing efforts to optimize outcomes and […]

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Medical Billing, Medical Billing AI, Medical Billing Tips, Medical Billing Trends, Patient Experience, Patient registration, Patient Responsibility, Practice Management, prior authorization, rcm, Revenue Cycle Automation, Revenue Cycle Management, Robotic Process Automation, RPA

For Medical Billers, Coding Accuracy is Valued Above All

September 21, 2024 / admin / Articles, Coding, Coding Accuracy, Coding and Billing, Coding and Documentation, Coding Intricacies, Coding versus Billing, Medical Coder, Medical Coders, Medical Coding, Medical Coding Accuracy, Medical Coding Quality
Female Medical Coder

Medical billing stands as a crucial link between healthcare providers and payers. At the heart of this process lies a fundamental principle that every medical biller must embrace: the paramount importance of accuracy in coding. We delve deep into why coding accuracy is not just a best practice, but an absolute necessity in medical billing, […]

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billing, Coding, Coding Accuracy, coding and billing, Coding and Documentation, Coding Intricacies, Coding versus Billing, Medical Billing, Medical Coder, Medical Coders, medical coding, Medical Coding Accuracy, Medical coding quality, rcm, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization

Common Behavioral Health Modifiers

August 19, 2024 / admin / Articles, Behavioral Health, Behavioral Health Billing, Modifier 25, Modifier 59, Modifier 95, Modifier AF, Modifier AH, Modifier AJ, Modifier Code, Modifier Codes, Modifier HE, Modifier HF, Modifier HN, Modifier HO, Modifier HP, Modifier HS, Modifier TD
Behavioral Health Modifiers

Behavioral health presents unique challenges and opportunities. One of the key elements in ensuring accurate billing and appropriate reimbursement is the proper use of modifiers. These two-character codes provide additional information about the services rendered, helping to paint a complete picture of the care provided. In behavioral health, where treatment often involves multiple providers, various […]

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Behavioral Health, Behavioral Health Billing, billing, Medical Billing, Modifier 25, Modifier 59, Modifier 95, Modifier AF, Modifier AH, Modifier AJ, Modifier Code, Modifier Codes, Modifier HE, Modifier HF, Modifier HN, Modifier HO, Modifier HP, Modifier HS, Modifier TD, Revenue Cycle Management

The Impact of ICD-11 on Medical Billing Practices

July 19, 2024 / admin / Articles, Healthcare, ICD-10 to ICD-11, ICD-11, International Classification of Diseases, International Classification of Diseases 11th Revision, Medical, Medical Billing
ICD-11

The healthcare industry is on the cusp of a significant transformation with the introduction of the International Classification of Diseases, 11th Revision (ICD-11). This comprehensive update to the global standard for health data, clinical documentation, and statistical aggregation promises to revolutionize medical billing practices. The key features of ICD-11 and its potential impacts on the […]

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healthcare, ICD, ICD Codes, ICD-10 to ICD-11, ICD-11, International Classification of Diseases, International Classification of Diseases 11th Revision, Medical, Medical Billing, Revenue Cycle Management

5 Ways to Boost Revenue Cycle Management

June 4, 2024 / admin / Articles, RCM, RCM Automation, RCM Challenges, RCM KPIs, RCM Metrics, RCM Optimization, Revenue Cycle, Revenue Cycle Automation, Revenue Cycle Management, Revenue Cycle Optimization, Revenue Optimization
RCM Optimization

If you’re running a healthcare organization, you know how crucial it is to have an efficient revenue cycle management (RCM) process. After all, it’s the backbone of your financial operations, ensuring that you get paid for the services you provide. But let’s be real, managing the revenue cycle can be a complex and daunting task, […]

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rcm, RCM Automation, rcm challenges, RCM KPIs, RCM Metrics, RCM Optimization, Revenue Cycle, Revenue Cycle Automation, Revenue Cycle Management, revenue cycle optimization, revenue optimization

Revenue Cycle Metrics for Healthcare Financial Success

May 3, 2024 / admin / Articles, RCM, RCM Challenges, RCM KPIs, RCM Metrics, RCM Optimization, Revenue, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Optimization, Revenue Cycle Process, Revenue Optimization
RCM Optimization

We all know how critical it is to keep a sharp eye on those revenue cycle metrics, right? Those numbers have the power to make or break your financial game. Understand them, optimize them – that’s the difference between rolling in dough or scraping by. But let’s keep it a hundred – digging into revenue […]

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rcm, rcm challenges, RCM KPIs, RCM Metrics, RCM Optimization, Revenue, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, Revenue Cycle Process, revenue optimization

Credentialing is Difficult; Outsource It

April 21, 2024 / admin / Articles, Credentialing, Credentialing Accuracy, Credentialing AI, Credentialing and Contracting, Credentialing New Providers, Credentialing On-Boarding, Medical Credentialing, Medical Credentialing AI
White Female Credentialing Professional

If you’re in the healthcare industry or deal with professionals who need to be credentialed, you know how complex and time-consuming the whole process can be. From verifying licenses and certifications to checking work histories and malpractice claims, credentialing is a massive headache that never seems to end. But here’s the thing – you don’t […]

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Credentialing, Credentialing Accuracy, Credentialing AI, Credentialing and Contracting, Credentialing New Providers, credentialing on-boarding, medical credentialing, Medical Credentialing AI, rcm, Revenue Cycle, Revenue Cycle Management

The Importance of Negotiating Payer Contracts

April 19, 2024 / admin / Articles, Payer Contract, Payer Contract Negotiation, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payer Enrollment, Payer Negotiation, Payer Regulations, RCM, Revenue Cycle Management, Revenue Cycle Process
Payer Contracting White Female

Healthcare providers, chances are you’re all too familiar with the headaches that come with negotiating contracts with insurance payers. It’s a tedious process that often leaves you feeling like you’re getting the short end of the stick. But here’s the thing – re-negotiating those contracts on a regular basis is absolutely crucial for the financial […]

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billing, Contract Negotiations, healthcare, Medical, Medical Billing, Payer Contract Negotiation, Payer Contract Re-Negotiation, Payer Contracting, Payer Contracts, Payer enrollment, Payer Negotiation, Payer Regulations, rcm, Revenue Cycle, Revenue Cycle Management

What to Expect When Outsourcing Medical Billing

April 17, 2024 / admin / Articles, Billing, Billing AI, Billing Analytics, Billing KPIs, Billing Revenue, Billing RPA, Medical Billing, Medical Billing AI, Outsourced Billing, Outsourced Medical Billing, Outsourcing
Medical Doctors Discussing Billing

If you’re a healthcare provider, dealing with medical billing is probably one of your least favorite parts of the job. It’s tedious, complicated, and takes you away from your real passion – caring for patients. That’s why many practices choose to outsource their medical billing to third-party companies that specialize in it. But what does […]

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billing, Billing AI, Billing Analytics, Billing KPIs, billing revenue, Billing RPA, Medical Billing, Medical Billing AI, outsourced billing, outsourced medical billing, Outsourcing, Revenue Cycle Management

Mastering Charge Capture: A Roadmap for Healthcare Providers

April 13, 2024 / admin / Articles, Automation, Billing, Billing Automation, Charge Capture, Charge Capture Challenges, Charge Capture Strategy, Coding, Coding and Billing, Denials, EHR, EMR, Missed Charges, Optimized Charge Capture, Revenue Leakage
Charge Master Work

If you’re a healthcare provider, you know how important it is to get paid accurately and on time for the services you provide. But the revenue cycle management process can be a tangled web of codes, documentation requirements, and insurance rules. One of the biggest pain points? Charge capture. Charge capture is the process of […]

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billing, Charge Capture, Charge Capture Challenges, Charge Capture Strategy, Denials, EHR, EMR, Medical Billing, Missed Charges, Optimized Charge Capture, Revenue Cycle Management, Revenue Leakage

Medicare Reimbursement: Understanding the Labyrinth

April 3, 2024 / admin / Articles, Geographical Practice Cost Index, Inpatient Prospective Payment System, IPPS, Medical Data, Medicare, Medicare 101, Medicare Coverage, Medicare Reimbursement, Medicare Severity Diagnosis Related Groups, MS-DRG, OPPS, PPS, Prospective Payment Systems

If you’re a healthcare provider or facility dealing with Medicare, one thing is certain – getting properly reimbursed is a maze filled with complex rules, convoluted paperwork, and often, sheer frustration. Medicare reimbursement is the lifeblood that keeps many healthcare operations afloat, but navigating its serpentine pathways can feel like a daily battle. Buckle up […]

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APC, APCs, CMS, Geographical Practice Cost Index, healthcare, Healthcare Billing, Inpatient Prospective Payment System, IPPS, Medical, Medical Billing, medicare, medicare billing, Medicare Part A, Medicare Part B, Medicare Part C, Medicare Part D, Medicare Physician Fee Schedule, Medicare Reimbursement, Medicare Severity Diagnosis Related Groups, MIPS, MS-DRG, OPPS, Prospective Payment Systems, Revenue Cycle, Revenue Cycle Management

Which CPT Codes are Used in Remote Patient Monitoring Billing?

March 30, 2024 / admin / Articles, Biling Codes, Billing, Remote Diagnostics, Remote Patient Monitoring, Remote Patient Monitoring (RPM), Remote Patient Monitoring Billing, Remote Patient Monitoring CPT Codes, RPM, RPM Billing, RPM CPT Codes
CPT Codes Remote Patient Monitoring (RPM)

If you’re a healthcare provider looking to get into remote patient monitoring (RPM), one of the first things you need to understand is how to bill for these services. And that starts with knowing the right CPT codes to use. RPM has been around for a while, but it really took off during the COVID-19 […]

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99091, 99453, 99454, 99457, 99473, 99474, billing, CPT codes, Healthcare Billing, Medical Billing, rcm, Remote Patient Monitoring, Remote Patient Monitoring Billing, Remote Patient Monitoring CPT Codes, Revenue Cycle Management, RPM, RPM Billing, RPM CPT Codes

Want to Start a Medical Billing Company?

March 28, 2024 / admin / Articles, Billing, Billing Challenges, Billing Services, Billing Staff, Medical Billing, Medical Billing Careers, Medical Billing Startup, RCM Startup, Start a Medical Billing Company, Start Your Own Medical Billing Company
Potential Medical Billing Company Owner

So you want to start your own medical billing company? It’s a lucrative industry with a ton of potential, but also one that requires some specialized knowledge and an understanding of the healthcare system. Don’t worry though, I’m going to walk you through all the key steps for getting a medical billing business off the […]

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billing, healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Startup, rcm, RCM Startup, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, Start a Medical Billing Company, Start Your Own Medical Billing Company

Claim Denial Kryptonite: Specialty-Specific Strategies to Supercharge Your Revenue Cycle

March 26, 2024 / admin / Articles, Claim Denials, Coding, Coding and Billing, Denial Kryptonite, Denial Management, Denied Claims, Denied Medical Claims, Diagnosticians, E&M code, Interventionists, Lex Luthor, Medical Billing, Proceduralists, RCM, Revenue Cycle, Revenue Cycle Management, Superman, Therapists
Denial Kryptonite

Let’s face it – claim denials are the bane of every medical practice’s existence. They’re like kryptonite sapping the strength from your revenue cycle. But what if we told you there was a way to turn those denied claims into a money-making superpower? No, we’re not peddling some snake oil solution. I’m talking about adopting […]

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billing, Claim Denial Kryptonite, Coding, coding and billing, Denial Kryptonite, Diagnosticians, E&M code, Interventionists, Kryptonite-Proof Strategy, Lex Luthor, Proceduralists, rcm, Revenue Cycle, Revenue Cycle Management, Revenue Cycle Management (RCM), Therapists

The Need for Transparency in Medical Billing

March 24, 2024 / admin / Articles, Billing, Billing Analytics, Billing Best Practice, Billing Transparency, CMS, Healthcare Delivery, Healthcare Outcomes, Medical Billing, Medical Billing Best Practices, Medical Billing Transparency, No Surprises Act
Medical Doctors Discussing Billing

If you’ve ever received a medical bill, chances are you were confused, frustrated, or both. The bills are often filled with inscrutable codes, massive dollar amounts that seem to make no sense, and a complete lack of clarity around what you’re actually being charged. It’s a systemic problem in the US healthcare industry that leads […]

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American Hospital Association, billing, Billing Systemic Reform, Billing Transparency, CMS, healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Service, Medical Billing Transparency, No Surprises Act, Revenue Cycle, Revenue Cycle Management

The Importance of Defining Medical Billing Workflows

March 22, 2024 / admin / Articles, Artificial Intelligence, Billing, Billing Best Practice, Billing Workflows, Claim Denials, Denial Management, Denied Claims, Financial Visibility, Medical Billing, Medical Billing Workflows, Robotic Process Automation, RPA
Medical Biller Techie

So you run a medical practice or healthcare facility. Congrats, you’re doing important work that helps keep people healthy. But have you put much thought into your medical billing workflows? If not, you really should. Billing is the lifeblood that keeps a healthcare operation afloat financially. It’s how you get paid for the vital services […]

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AI, Automation, billing, Billing Workflows, Financial Visibility, healthcare, Healthcare Billing, Medical, Medical Billing, Medical Billing Service, Medical Billing Workflows, rcm, Revenue Cycle, Revenue Cycle Management, revenue cycle optimization, RPA

Revenue Cycle Automation Tools: Streamlining Financial Operations for Healthcare Providers

March 20, 2024 / admin / AI, Articles, Claims Scrubbing, Denial Management, Eligibility Verification, Intelligent Data Capture, ML, OCR, Payment Posting, Revenue Cycle Automation, Revenue Cycle Automation Tools
RCM Automation Expert

The healthcare industry has long been grappling with the complexities of revenue cycle management (RCM), a critical process that encompasses all administrative and clinical functions associated with capturing patient service revenue. Traditionally, revenue cycle management has been a labor-intensive and error-prone process, often plagued by inefficiencies, delays, and compliance issues. However, the advent of revenue […]

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Appeal Management, Automated Eligibility Verification, Claims Scrubbing, denial management, Eligibility Verification, Intelligent Data Capture, OCR, Optical Character Recognition, Payment Posting, Predictive Analytics, Revenue Cycle Automation, Revenue Cycle Automation Tools, Revenue Cycle Management, Robotic Process Automation, RPA

The Digitization of Medical Billing: How Electronic Systems are Streamlining the Revenue Cycle

March 18, 2024 / admin / Articles, Billing, Billing AI, Billing Analytics, Billing Automation, Billing Process, Electronic Medical Billing, Electronic Medical Billing Systems, Future of Medical Billing, Medical Billing Systems, Revenue Cycle, Revenue Cycle Management, Revenue Optimization, Robotic Process Automation, RPA, RPA Adoption
Electronic Medical Biller

In the healthcare ecosystem, one aspect that has undergone a remarkable transformation is the way medical bills are processed and submitted. Gone are the days when mountains of paper claims and endless filing cabinets were the norm. Instead, healthcare providers have embraced the power of electronic medical billing systems, revolutionizing the revenue cycle management process and […]

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Better Patient Experience, Billing Automation, Billing Process, Digitization of Medical Billing, Electronic Medical Billing, Electronic Medical Billing Systems, Future of Medical Billing, Healthcare Billing, Healthcare Billing Systems, Medical, Medical Billing, Medical Billing Systems, Revenue Cycle, Revenue Cycle Management, Robotic Process Automation, RPA
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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

  • California Medical Billing, Credentialing

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