Insurance Eligibility Verification is the process in which the eligibility of a patient’s insurance benefits and coverage are verified either by call or through the insurance portals so the physicians can provide the medical treatments accordingly and also keep the patients informed about the payment responsibility in advance. This process can be slightly cumbersome and complex as it involves calling… Read more »
Charge Entry in Medical Billing is one of the most vital scopes as it involves financial data and is directly associated with the claim reimbursement and the physician’s or medical practice’s revenue flow. The process of Charge entry in medical billing involves validating the medical codes and assigning appropriate charges to the procedure and diagnosis codes to ensure the claims… Read more »
Medical billing and coding is a cycle of efforts towards getting the medical claims reimbursed with full payment and ensuring the physician or the medical practice has received their due payments within the standard turn-around time (TAT). Every scope in Medical billing has a timeline or TAT and failing which will affect the overall timely filing limit (TFL) of the… Read more »
Payment posting is a crucial part of medical billing as it is directly associated with the overall collections for the physician and medical practice. Every scope of Medical Billing and Revenue Cycle Management Services plays a major role in claim reimbursement and payment posting shares equal contribution in getting a claim fully paid, tallied, and closed. Payment posting is entering… Read more »
2020 has been a challenging year for the Global healthcare sector, which resulted in sweeping changes affecting healthcare and Medical billing outright. With these challenges and changes anticipated to carry over, Medical Billing in 2024 as predicted will see a lot of updates, advancements, revised medical billing and coding guidelines, compliances, and regulations. Read further to educate yourself with the… Read more »
Every Physician and Medical Practice strives toward improving the Medical Billing process and achieving better collections. However, end up depleting all of their efforts and focusing on patient care and quality treatment, apparently as that is the core of their business. As a result, obliviously improvising the medical billing process takes a back seat as it needs time, dedication, and… Read more »
Mobile Charge Captures is an AI innovation to enhance the clinical documentation and Charge Capture for physician services into the app integrated from the physician’s mobile to the EHR. Unlike the paper-based charge capture process, this advanced technology has improved the Charge Capture Process by eliminating the chances of missed charges due to incomplete or inaccurate documentation. The impacts of… Read more »
Keeping the Medical Practice revenue flow intact and evergreen requires constant effort from physicians and Medical practices. Overcoming financial lags owing to claim denials and keeping up with the ongoing changes and regular updates are prerequisites for any practice to ensure the monthly collections and claim reimbursements are intact. There are various reasons why a claim can get denied and… Read more »
Select the Best Anesthesia Medical Billing Company in 2024 Medical Billing for Anesthesia is comprehensive and complex making it difficult for Anesthesia Practice to handle both patient care and Revenue Cycle Management In-house. Therefore Outsourcing works best for Anesthesia Practice, however, choosing the right Medical Billing Partner is the key to the success of the practice and patient care. If… Read more »
Medical Billing denials management and revenue integrity are critical aspects of healthcare organizations’ financial stability and operational efficiency. Artificial intelligence (AI) can play a significant role in addressing these challenges and providing an advantage in managing denials and ensuring revenue integrity. Here are some ways AI can be leveraged in this context: Automated Denials Analysis: AI-powered algorithms can analyze vast… Read more »
Whether you are a new Provider or an established healthcare practice, providing extra care to the medical claim processing sector is the only way to improve cash flow. Although patient care is the key focus of Physicians, many are new to the industry and lack the experience to handle medical billing. Well, it doesn’t mean that experienced Providers are well-versed… Read more »
The diagnosis Code ICD -10 CM (International Classification of Diseases 10th Revision Clinical Modification) is the crucial part of Medical Coding which can affect the financial aspect of the claim if not documented appropriately. Assigning accurate codes requires the physician to provide complete and accurate clinical documentation of the procedure, however with the regular update of Medical Codes and the… Read more »
While practices strive towards efficient and qualitative medical billing and coding to enhance claims first-pass rate and monthly collections; conversely claim denials, rejections and low payments are inevitable. Medical Practices lose a tremendous amount of revenue by not working on denials and ignoring unpaid claims. These missed revenues can be earned by reworking and appealing with the payer, the process… Read more »
As healthcare providers prepare for 2024, they are faced with a variety of challenges and uncertainties, from changing reimbursement models to evolving regulatory requirements. One of the most critical aspects of healthcare practice management in 2024 is revenue cycle management (RCM), which is the process of managing the financial aspects of patient care, from the point of service to payment… Read more »
Electronic Medical Records (EMR) is the electronic version of patient medical reports or charts which includes information like patient’s treatment, diagnosis, procedure, lab reports, etc. In short, it details what happened during the patient’s visit to a Medical Practice or Hospital. EMR emerged in the year 1960 and has seen constant changes and upgrades since then, the current version of… Read more »
In any scope of work, there is always room for improvement. Revenue Cycle Management is the backbone of the healthcare industry and has continuous room for improvement with the ever-changing revision of Medical procedures, technological developments, and Insurance policies. The unceasing changes and updates in the healthcare industry and the revenue cycle management process require Providers, Medical staff, medical billers, and coders… Read more »
Dealing with Medical Billing claims rejections can be frustrating and cumbersome, but there are several quick and easy solutions you can try to clear up any confusion. Here are some steps you can take: Review the rejection letter Carefully read the rejection letter or Explanation of benefits (EOB) provided by your insurance company. Look for specific reasons why the claim… Read more »
Preventing healthcare fraud and abuse is essential to maintain the integrity of the healthcare system, protect patients and Protected Health Information (PHI), and ensure that resources are used efficiently and appropriately. Healthcare fraud refers to intentional deception or misrepresentation with the aim of gaining unauthorized benefits or payments, while healthcare abuse involves practices that are inconsistent with accepted medical, fiscal,… Read more »
Every physician and medical practice suffer with unpaid claims and payment rejections for the service rendered. While it is obvious that the physician and the medical practice are entitled to get the payment for the services rendered which cannot be denied practically. However going by the insurance policy and the coverage and benefits applicable to the policy member, the insurance… Read more »
The U.S. healthcare industry and Revenue Cycle Management (RCM) sector is fast evolving with huge technological advancements necessitating constant changes and introducing new trends into process efficacy. These upgrades and developments are more into effect after the COVID pandemic as a result of certain process implications and with the best efforts towards adaption to the ongoing requirements. Let us discuss… Read more »
Are you new to Medical Billing Outsourcing and exploring the option for your practice? Finding the best partner for your Medical Billing Services can be a tedious and complex task. However, having an established and experienced Medical Billing and Coding expert to work on your claims can be the best solution for your Practice. Therefore choosing the best Medical Billing… Read more »
Insurance Policies go through a cycle of regular changes affecting Medical Billing and Claims Processing. To add fuel to the fire, procedures requiring Prior Authorization are often updated and changed and the requirements vary with each payor; making it even more difficult and complicated for the Physicians, Billers, and Coders to ascertain the particular medical procedure requires Prior Authorization and… Read more »
Conquering cardiology billing challenges requires a comprehensive and strategic approach to ensure accurate and timely reimbursement for services provided. The field of medical billing is complex and subject to frequent changes in regulations and coding guidelines. Here are some proven strategies to help you navigate and overcome cardiology billing challenges: Stay Updated with Coding Guidelines and Regulations: Cardiology billing is… Read more »
A well-managed billing process with dedicated billing staff can ensure cleaner claim submission increasing claims first-pass rate and reducing denials, which is the goal for any Medical Practice. Radiology Billing is a vast process mostly handled in high volume. With such a high volume of claims processed, even by the experienced billers and coders, eliminating claim denials can seem inevitable;… Read more »
The objective of Healthcare and its benefits is mostly gauged basing patient care, satisfaction, medical facilities and specialties the medical practice and physician can offer. However, the requirements of the physician and the medical practice in terms of their financial needs and achievements, business goals, claims processing and medical reimbursements are seldom considered. Nevertheless the obligations and struggles involved in… Read more »
Medical billing is a tricky job that accounts for intense labor, huge investment, and valuable time. The new healthcare reforms that revolutionized the US healthcare industry in recent times have complicated medical billing operations. Because of this reason, healthcare organizations and independent practitioners face a hard time tackling billing operations while focusing on patient care. The best solution would be… Read more »
Medical billing can be a complex and time-consuming process, and physicians often face several unexpected challenges in the Medical billing process affecting the entire Revenue Cycle Management. Listed below are some common challenges faced by Physician in medical billing: Lack of understanding of billing codes and regulations: Medical billing involves a significant number of codes and regulations that can be… Read more »
Claim denials and Denial Management are the most challenging area in Healthcare and Medical Billing. Every physician, medical practice, and the medical group is striving towards achieving quality Medical Billing and Coding with conscious efforts towards keeping claim denials at bay. However, billing and coding errors seem to be unavoidable owing to various reasons, making efficient Denial Management process the… Read more »
Improving medical billing and coding processes can significantly enhance claim rates and revenue for healthcare providers, which is the primary goal for any business. Here are some suggestions to help physicians and Medical Practices achieve enhanced financial returns: Accurate Documentation and Coding: Ensure that all patient encounters are accurately documented and coded with the appropriate diagnosis and procedure codes. Proper… Read more »
US healthcare facilities and companies sign up contracts with a wide range of insurance companies every year. All payers have different policies, standards, parameters and regulations to follow. Therefore, keeping track of all contracts is an enormous task, especially when the US healthcare industry is observing so many new reforms like the ICD-10 Code Set Implementation. To streamline the contract… Read more »
One of the major mistakes that Providers and healthcare facilities make is to neglect the AR build-up and focus more on billing the incoming claims. The abandoned AR will be converted into hard cash only if there is a prompt follow-up. Else, the revenue cycle management is going to be greatly affected by the consequences. Providers and healthcare facilities have… Read more »
Medical Billing Denials are the most common concern of every practice. Claims denials and rejections are inexorable however they can be controlled to a greater extent with necessary steps and obligatory checks. Let us discuss in detail the causes of claims denials and some tips to avoid them. Most common reasons for Medical Billing Denials: A claim can be denied… Read more »
Medical billing claim denials affect physician practice and cash flow. By reducing the claim denials rate, you can enhance your practice profitability and reduce administrative costs. To overcome the issue of a claim denial, it is important to understand the common reasons for claim denial. Let us discuss the most common reasons for medical billing claim denials. Incorrect Patient Identifier… Read more »
When it comes to active healthcare claims processing, it is essential to create a system that maximizes efficiency in handling denied claims. Most of the Healthcare entities get too worried when it comes to working claims, particularly when the claims are denied. It is essential to identify the prospective income lost and begin an effective medical claims management service for… Read more »
Medical practices and physicians are more focused on patient care, and patient satisfaction and thereby improve and develop their business. With these priorities consuming most of their daily chores, Medical Billing and claims processing can take a second seat or lag down with quality issues obliging the physicians or medical practices to turn towards Medical Billing Outsourcing. Nevertheless, Outsourcing Medical… Read more »
The Merit-based Incentive Payment System (MIPS) is a program developed by the Centers for Medicare and Medicaid Services (CMS) in the United States. It aims to provide incentives to physicians for quality and value-based care. While each specialty-based physician may have specific challenges in participating in MIPS due to their unique workflow, there are several strategies they can employ to… Read more »
Timely retrieval of Medical Records is fundamental to successful Revenue Cycle Management (RCM) and also to plan patient procedures based on the previous health history. The availability of proper Medical Reports or documents is crucial to perform effective Medical Billing and Coding. Being negligent in Medical Records Management not only impede in patient treatment but also affects claim reimbursement and… Read more »
Medical Billing for Anesthesia is comprehensive and complex making it difficult for Anesthesia Practice to handle both patient care and Revenue Cycle Management In-house. Therefore Outsourcing works best for Anesthesia Practice, however, choosing the right Medical Billing Partner is the key to the success of the practice and patient care. If you are looking for a guide to choosing the… Read more »
Claim Denials are inevitable in-spite of various quality checks and measures in place. Nevertheless, keeping the claim denial ratio reduced and under control depends upon having an effective Denial Management Service in place. This articles guides on how to reduce rejections and claim denials in Medical Billing with Effective Denial Management Process. Before we discuss on ways to reduce claim… Read more »
Medical Records Management has been the core requirement for a smooth and successful practice from ages back, although the method of storing and maintaining medical records has significantly evolved with each changing era and with technological advancements; the importance of retaining Medical Records intact as per the US federal law for a minimum of seven to ten years is crucial… Read more »
Medical Practices and Physicians are always engaged with patients and patient care; Physicians and staffs in the healthcare facilities are always busy already wearing multiple hats and handling various necessities for the patient. It can be difficult for them to take the time out to handle Medical Billing which requires undivided attention, leading to a lot of dips and lags… Read more »
Medical Records Management is indeed a tedious but the most important task for the Physicians and Medical Practice, which makes them liable to higher risk, penalties and legal issue if mishandled and missed to follow the Protected Health Information (PHI) compliance measures. While the U.S. federal government mandates the Patient Medical Records to be retained and maintained for around 7-10… Read more »
Managing Physician Practice has never been a cakewalk more over the novel changes owing to recent global COVID and pandemic attack has worsened the situations which have left the physician lookout for alternative supports for efficiency in Practice Management. Here are some Top Physician Management tips for Streamlining your Practice Process Advancement and Streamlining: Analyze your current Physician Practice Management… Read more »
Keeping Medical Practice Profitable requires an enduring effort towards Medical Billing and Revenue Cycle Management Services. Balanced attention towards both Patient Care and Medical Billing is mandatory for the success of Medical Practices and Physician groups. While the Physicians and Medical Practitioners are more inclined towards patient care, customer satisfaction and business development, Medical Billing which is the backbone of… Read more »
Digital and technological innovations have transformed the healthcare care -sector and Revenue Cycle Management in Medical Billing significantly over the past few years. As the saying goes “Necessity is the mother of inventions” the Novel Corona Viral attack and the global pandemic situation has necessitated the need for technological advancement, Process Automation and integration of artificial intelligence to cope up… Read more »
Physicians Credentialing privileges and status is directly linked to revenue flow of the practice. Delayed or expired credentials can affect the Medical Billing and Reimbursement process. Planning on the Physician Credentialing or Re-credentialing requirement in advance saves revenue loss to greater extend, however handling Physician Credentialing can be a cumbersome and laborious task involving lot of paper-works and supportive documents;… Read more »
Healthcare Contract Management majorly deals with management of contracts between payor and providers. Complexities involve with the ever-changing policies, regulations, compliance and insurance charges to be monitored and tracked for efficiency and quality. It can get difficult for physicians and medical practices to keep a track of the contractual agreement and focus on patient care and achieve maximum reimbursement. With… Read more »
Physicians and Medical Practices are striving towards efficient and enhanced Denial Management to achieve their financial goals. To curb claim denial completely seem to be an inevitable challenge, however, keeping claims denials under standard quality percentage can reduce revenue loss and effort spent on clearing them. Read below to know the Tips and Tricks for Better Healthcare Denial Management. Denial… Read more »
Getting due payment or reimbursement without any shortfalls is a primary focus for any Physician or Medical Practice. However real-time scenarios can give a different picture with reasons such as low paid, rejections, denials and payment delays. While getting 100% timely payment for all claims processed might seem impractical, working towards achieving maximum reimbursement within the turnaround time (TAT) and… Read more »
Medical Billing Companies are third party service providers striving towards achieving the financial goals of any Medical Practice or medical group while the physician renders his complete attention on patient care and satisfaction. While handling Medical Billing In-house may seem successful on the surface; apparently diving deep down into the process level and looking into the numbers can say a… Read more »
Physician credentialing is a mandatory process to generate revenue. Being Out of Network (OON) can turn out to be complicated and challenging in terms of getting the reimbursement for service rendered. Therefore every physician aims to get credentialed and being In-Network with the top insurance careers to ensure they can get their claims processed effortlessly and stay away from the… Read more »
Every Medical Specialty has its own unique significance and complexities, the deeper and detailed the procedure, billing process also gets detailed and intricate. Cardiology is one such specialty that deals with severe and chronic conditions which make Cardiology Billing Challenging. Let us discuss the major pitfalls in Cardiology Medical Billing and how practices can deal with them. Follow Coding Updates… Read more »
While both In-house billing and outsourced billing have their own pros and cons, studies and testimonials have proved Outsourcing Medical Billing Process to be more beneficial and the best choice for any setup. Read through the article to understand why Outsourcing Medical Billing is the better option in comparison to In-House Billing. Medical Billing can be a Complicated and Arduous… Read more »
Goal of any Physician or Medical Practice is to increase business by a regular flow of patient appointments with new and existing patient visits. Patient retention is the most critical part when compared to generating new appointments and marketing. There are many factors that play a major role on retaining patients who are the core asset of any practice. Patient… Read more »
Surprise bills are the most common concern of affordability for many In-Network and Out of Network (OON) patients. These bills are least expected and financially unmanageable as most of the times patients are unware that they had got service from an Out of Network provider until they get their Medical bills. Such unanticipated Medical Bills when patients are getting treated… Read more »
Medical Billing is the backbone of your practice which embraces the bottom-line of your business. Efficiency is the cornerstone for any Medical Billing Process, without which your Practice may seem unmanageable. However, with Patient care as the prime function, efficiency in Medical Billing can be challenging to be achieved. A physician’s core focus is fully tied up with the daily… Read more »
Insurance carriers have various checks and parameters that contemplate towards 100% reimbursement. Payments for Physician services are considered taking into account of each and every process and task involved right from patient visits, consulting, prescribing medications, treatments and procedures, and even the after care services. Hence it is essential for any provider to document every process in detail. Missed or… Read more »
Most of physicians and Medical Practice have agreed, Medical Billing Outsourcing as beneficial in comparison to In-house billing. While the benefits Outsourcing is long-established resulting in an increased number of physicians and Medical Practice shifting from in-house billing to Outsourcing, there are a lot of areas to check and validate while choosing a suitable Medical Billing Partner. Let us look… Read more »
First and foremost step to streamline any process is to do in depth analysis to cognize every niche to avoid common and recurring pitfalls. Recognizing the common pitfalls in your Anesthesia Billing can help in developing a streamlined Revenue Cycle Management Services. Unlike billing for various other medical specialties, Anesthesia billing can be perceptibly complex for its difference in charges… Read more »
While patient care can be the primary focus for any physician or practice, it is also quintessential to ensure the other areas such as support staff, administration, financial management, medical billing and coding are equally attended and addressed to acquire targeted results continuously. Physician Practice Management is an indispensable component for any Medical Practice irrespective of their size and bandwidth… Read more »
About Surprise Bills “Surprise bills” are charges billed when an insured person gets treatment from an out-of-network provider due to any emergency situations. Surprise bills are very common when you visit an emergency room, or inpatient facility, the reason is when in an emergency situation you completely miss to cross check if the provider is in-network, similarly, when availing inpatient… Read more »
Almost every physician and practice thrive towards adopting a Successful Healthcare Revenue Cycle Management Solutions, however handling both patient care and billing together might be distressing, affecting the quality of both areas and creating stress in the work environment. Outsourcing has proved to be the best practice to handle medical billing and coding successfully. While deciding to outsource most of… Read more »
Most of the providers don’t know about the total number of claims denied in the first phase. This is among the primary topics surveyed & discussed, and providers are stunned by finding the cumulative percentage of revenue lost due to those initial denials. The need for medical documentation and the absence of authorizations are the most well-known reasons for claims… Read more »
Anesthesia billing has ever been more complicating and daunting unlike billing for other medical specialties. Attaining maximized revenue for Anesthesia billing is possible only if each and every member right from the physician to the biller and coders involved in handling the medical report work productively, keeping in mind the nuances of Anesthesia billing. Even a simple error or a… Read more »
Outsourcing medical billing and coding proves to be most efficient and productive solution for revenue cycle management. The greatest challenges encountered by practices are loss of revenue due to unsettled transaction. Not all providers can naturally handle the billing process in house, glitches like billing and coding errors, denial and rejected claims, staff attrition and absenteeism, hiring and training new… Read more »
While outsourcing Medical Billing services is not a new concept, practices and hospitals are still in a delicate situation when deciding to outsource their billing process. The major cause of indecision is the worry of putting their billing service into wrong hands and the daunting task of identifying the right billing partner, fear of losing control over your business, additional… Read more »
In any scope of work there is always room for improvement. Revenue Cycle Management being the backbone of healthcare industry has continuous room for improvement with the ever changing revision of Medical procedures, technological developments and Insurance policies. The unceasing changes and updates in the healthcare industry and the revenue cycle management process requires Providers, Medical staffs, medical billers and… Read more »
Medical billing and coding is the meticulous process of tracking and handling the medical claims efficiently between the providers and the payers to ensure the provider receives full reimbursement for the service rendered. This signifies the importance of the medical billing process for any practice to keep their business running smoothly and successfully. Every medical procedure differs by its scope… Read more »
The reach of technological innovation keeps on developing, changing all industries as it advances. Innovation is progressively playing a major role in the medical coding process and from charge entry to claim submission as well. Utilize the most recent technologies to get the greatest advantages in the healthcare field. Let us take a closer look at the latest technological innovations…. Read more »
The radiology physician’s major goal is to receive reimbursement quickly. It can be achieved by error-free claim submission on time. This helps the physician to improve the practice’s cash flow and minimize the overall operational cost. Sometimes, radiology claims are denied due to some reasons. Let us discuss the radiology claims denial reasons and how to avoid them. Most common… Read more »
Cardiology billing is one of the most complex medical billing processes for physicians and billing experts. Policy changes made by the insurance payers, new regulations announcements have made cardiology billing a more complex one. These challenges impact the physician’s revenue cycle. Let us discuss the challenges in cardiology billing. Understand Modifiers for Cardiology MGSI knows that Cardiology billing is difficult… Read more »
Healthcare Revenue Cycle Management Operations includes Medical Billing, Denial Management and patient payment collections, etc. Through revenue cycle management, physicians can achieve faster and accurate reimbursement. But in recent years, healthcare revenue cycle management is a difficult task due to various reasons such as Tangled Payer Contracts Increased Patient Financial Responsibility Increased Regulatory Demands Let us discuss a few techniques… Read more »
The first step that helps streamline the claims-submission process is adopting a high-quality insurance eligibility verification system. However, most healthcare facilities and Providers do not have the time or labor to focus on such administrative functions. End of the day, it is their revenue cycle that gets affected badly. A survey says that most of the billing errors could be… Read more »
The advent of avant-garde technologies and leading-edge software systems have taken the healthcare revenue cycle management market’s growth to a whole new level. The adoption of Electronic Health Records (EHR), cloud-based solutions, and denial management fixes in almost every single Practice is another reason for this huge growth. A recent report named, ‘Revenue Cycle Management: Global Market Analysis, Insights and… Read more »
There has been a huge downfall in the revenue generated by cardiology medical billing over the last few years due to the new medical reformation. Adding to the burden, the Medicare fee reduction has affected the cash flow furthermore. Echo services like Doppler and Color flow witnessed many changes and so are the other categories. Understanding the new code set… Read more »
Preceding the revenue generated by healthcare organizations, there is a whole series of complex steps involved, collectively known as medical claims processing. Healthcare Providers’ reimbursements depend purely on the accuracy of medical claims billing. Therefore, it is essential that the billing staff pose utmost care while carrying out medical billing operations. But, how is medical claims processed in healthcare? To… Read more »
Performing medical billing and coding functions for anesthetic services is not the same as billing common healthcare claims. It involves a whole set of different procedures and there is a lot of opportunity for making minute errors. Anesthesia billing is done based on some crucial factors, including base units, time units and modifiers. With new medical reforms revolutionizing the US… Read more »
Medical billing is a tricky job that accounts for intense labor, huge investment, and valuable time. The new healthcare reforms that revolutionized the US healthcare industry in recent times have complicated medical billing operations. Because of this reason, healthcare organizations and independent practitioners face a hard time tackling billing operations while focusing on patient care. The best solution would be… Read more »
What is the most problematical and tedious process of all the medical billing functions? ‘Physician credentialing’ was the answer provided by most of the healthcare organizations. It is not only a long process but an expensive one too. Credentialing a single Provider can take at least 4 to 6 months and range from $500 to $3600 approximately. In addition, provider… Read more »
Efficiency in medical billing and coding processes is the key to profitable reimbursements. Healthy revenue cycle management means healthcare organizations are running successfully. However, this scenario is not true in all cases. Many healthcare practices and independent Providers are facing a lot of struggles to perform medical claims billing and processing efficiently, today. One of the prime reasons is the… Read more »
The financial health of a healthcare organization is determined by the performance of the RCM (Revenue Cycle Management). It has become a huge challenge for Practices to keep the RCM from failing as the healthcare industry shifted from fee-for-service model to value-based models like Alternative Payment Models (APM) and Self-pay in which patients take up more financial responsibility. These payment… Read more »
Running a successful medical practice means offering the best patient care, carrying out efficient medical billing and collections and ensuring a healthy cashflow. However, only a few medical practices in the US taste the fruits of success. There are many factors that affect the success rates and one of them include the recent healthcare changes like ICD-10 implementation. The need… Read more »
Insurance eligibility verification is an integral part to any medical billing procedure. Patients providing incorrect details cause most of the delays in claims. Often the healthcare staff forgets to update the information and these directly result in your healthcare facility losing out on fast cash flow. This is precisely why outsourcing billing services to a medical billing service provider have… Read more »
Can Medical Billing Companies Meet Your Need Beyond Filling Claims? The reason why so many physicians and healthcare facilities hire medical billing companies over in-house billing systems is quite simple. Medical billing companies make the process of filing claims seamless and super-fast which results in a massive growth in revenue cycle management for the healthcare provider. However, there are more… Read more »
Here are the facts to validate: Deciding on a vendor requires a lot of research. But asking the vendors for certain specific information can make the task a lot easier. Similarly, medical billing is also a very crucial process that requires time, dedicated staff, knowledge and accuracy.. Associating with a reputable and professional medical billing company can resolve a lot… Read more »
Mobile Charge Capture is a software platform designed – to improve the efficiency of physicians by effective management of billing time and communication billing and coding outside the office setting. The software captures charges and patient data right at the point of patient contact along within a secure HIPAA compliant messaging. Charge capture is accessible on a mobile device –… Read more »
The medical and healthcare industry is constantly changing. Doctors and medical professionals can use outsourced medical billing services in a bid to keep abreast of the latest rules and regulations. Outsourcing billing services to a Medical billing company enable physicians to focus on patient care and adhere to high standards of medical diagnosis and interventions. Physicians who outsource medical billing… Read more »
CMS sent out a final rule regarding MIPS for 2018 on Thursday, November 2nd, 2017. In this rule Medicare has included information regarding exemptions for areas impacted by recent hurricanes. Certain counties and parishes in Florida, Texas, Louisiana, Georgia and South Carolina will be automatically exempt from reporting MIPS for year 2017. Physicians and providers are still allowed to report… Read more »
Healthcare is often reactive, rather than proactive, when it comes to opportunities for improvement. It is often a race to fix what went wrong, not institute infrastructure to prevent it. Tied to the above is the fact that EMR/EHR is a significant outlay of cash for providers for something that is not directly a medical product. EMR/EHR is not treating… Read more »
The news of recent account breaches at major free email providers brings into focus the importance of using HIPAA compliant email services. One free email provider admitted to over a billion user accounts being compromised. More recently the same email provider found and patched a security weakness that allowed users’ email accounts to be accessed by foreign hackers without the… Read more »
A review as it relates to denials or delays in payments of a practice’s A/R (account receivables) may result in findings that insurance eligibility-verification is not being done correctly or at all by the office staff. Today’s healthcare environment has produced confusion on insurance plans not only to physician practices, but to patient’s with the plan. Many of the affected… Read more »
Correct, detailed physician documentation, coding and billing is and continues to be of the upmost importance as we continue to see healthcare and reimbursement changes. As an example, the Centers of Medicare and Medicaid Services (CMS) in 2017 will say “bye-bye” to PQRS, Meaningful Use, and the Value based Modifier- (kind of). There is a constant need to keep the… Read more »
ARE YOU INFORMED ABOUT MIPS? Medical Billing Collections Affected? Medicare Provisions Related to the Merit-Based Incentive Payment System (MIPS) The Quality Payment Program changes the way Medicare pays providers and offers financial incentives for providing high value care. The maximum Negative adjustments for each year are: 2019 — 4% 2020 – 5% 2021 – 7% 2022 and after – 9%… Read more »
What is MACRA? Congress passed the Medicare Access and CHIP Re-authorization Act (MACRA) on April 16, 2015. Section 501 of MACRA requires CMS to remove Social Security Numbers from Medicare ID cards and replace existing Medicare Health Insurance Claim Numbers (HICNs) with a Medicare Beneficiary Identifier (MBI). SSNRI: The Medicare Access and CHIP Re-authorization ACT (MACRA) of 2015 requires the… Read more »
Often when a Provider or Medical Group is looking to outsource their medical billing and collections for the first time, they are perplexed by the Percentage pricing model. Since they have never outsourced before, and were depending on their own staff for handling the medical billing and collections activities, they are not in a position to understand the benefits… Read more »
Mergers and acquisitions in the US healthcare payer space has become the ‘talk of the town’ recently. The idea of consolidation was to build strength and boost growth by acquiring smaller companies. It is not a new concept, but has been happening for quite a long time in several industries. Some industries that have faced significant amount of consolidations include… Read more »
One factor of reimbursment that highly concerned Healthcare Providers and Facilities was the SGR (Sustainable Growth Rate) payment cut proposal. However, it took a complete rollback when the US senate passed the SGR repeal bill on Apr 14, 2015. Hereafter, Providers need not bother about the SGR rate cut, which kept increasing every year and mounted to 21% at the… Read more »
Since the inception of the Affordable Care Act (ACA), the US healthcare entities have been striving to improve the way patient care is provided by Providers. Evidently, it has brought out various reforms that focus more on the quality of service rendered to patients. In that list of reforms, a few that provide incentives are the Medicare Electronic Health… Read more »
The US is facing an acute shortage of Primary Care Providers and the number of PCPs per 10,000 people has steadily been on the decline. As part of the healthcare changes in 2013 which includes bringing millions of uninsured into the Healthcare net, Medicaid payments have been increased for qualifying Primary Care physicians for nearly 146 different Primary Care… Read more »
