Category: Blog

Steps-to-reduce-claim-denials

Effective Revenue Cycle Management Strategies to Reduce Denials & Boost Revenue

Healthcare organizations consistently grapple with the complexity of overseeing their revenue cycles—a comprehensive process spanning patient registration, appointment scheduling, and concluding with balance payments. Yet, a pivotal hurdle disrupting this cycle’s seamless operation is the prevalent occurrence of claim denials. Vital for any healthcare institution’s financial well-being is the imperative to diminish these denials and […]
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Darker side of AI in healthcare

AI in Healthcare: Revealing the Risks and Challenges Ahead

AI represents a promising frontier, especially in healthcare, where leveraging vast information could revolutionize problem-solving. However, a shadow looms over AI, as anticipated by many. In the realm of health insurance and patient care denials, AI has already stirred controversy, leading to a notable class action lawsuit. According to reports from healthcare News, Health Insurance […]
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Physicians-face-dual-burden-between-patient-care-and-medical-coding

Clinicians Struggle with Medical Coding Amid Patient Care Responsibilities

Presently, healthcare professionals face growing administrative demands alongside their patient-focused duties. A pivotal challenge among these is medical coding, essential for various reasons. It ensures adherence to billing standards impacting reimbursements, meets quality metrics established by healthcare entities and insurers, and guarantees precision in diagnoses recorded for billing purposes. Yet, the task of accurate coding […]
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Value-Based-Care-Plans-improved-health-outcomes-for-MA-members

Medicare Advantage Value-Based Care: Enhanced Health Outcomes

Alongside its positive impact on health outcomes, the Medicare Advantage value-based care plans implemented by an insurance provider resulted in a significant $8 billion in cost savings throughout 2022. Reports from the payer revealed that Medicare Advantage beneficiaries under value-based care exhibited improved health conditions, marked by reduced inpatient admissions and emergency room visits. The […]
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High-time-to-ponder-over-a-new-Outsourcing-Model-in-Healthcare

The Rise of Hybrid Global Outsourcing Models in Healthcare

Given labor shortages and financial constraints, fully managed hybrid outsourcing solutions are increasingly gaining prominence. Hospitals and provider organizations grapple with staffing deficiencies across various departments, with the revenue cycle facing considerable strain. A recent survey among medical group leaders highlighted coders as the most challenging role to fill, closely followed by billers, schedulers, authorization […]
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ICD-10-codes- Thanksgiving 2023

11 Crazy ICD-10 Codes for Thanksgiving

Thanksgiving Day: The wonderful day when loved ones get together to share thanks for the blessings in their lives. Do you agree that the day will go according to the plan? No! It’s not; thankfully ICD-10 codes are here to help us to code holiday havoc. We have compiled a list of codes that you might […]
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Benefits-of-ABNs-for-Providers-and-Medicare-beneficiaries

Understanding ABNs for Providers and Medicare Beneficiaries

The Advance Beneficiary Notice (ABN), Form CMS-R-131, issued by the Centers for Medicare & Medicaid Services (CMS), holds immense importance for healthcare providers, revenue cycle teams, and Medicare beneficiaries. What is an ABN (Advance Beneficiary Notice)? An ABN, formally extended to Medicare Fee-for-Service (FFS) beneficiaries, precedes outpatient services like labs, imaging, physical therapy, or observation. […]
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Physicians-face-potential-Medicare-reimbursement-cuts-in-2024

Anticipated Decrease in Medicare Reimbursement for Physicians in 2024

The Final Decrease Is Influenced By Add-On Codes and Regulatory Obligations On November 16th, the Centers for Medicare & Medicaid Services (CMS) released the finalized rule for the 2024 Medicare Physician Fee Schedule (MPFS) in the Federal Register. While the policies exhibit several positives, especially in primary care, telehealth, and behavioral healthcare, CMS remains dedicated […]
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The-top-10-transformative-technology-trends-reshaping-healthcare-in-2024

Top 10 Healthcare Technology Trends 2024: AI, Virtual Care, and More

Healthcare is facing an escalating crisis due to workforce shortages, expected to persist into 2024. This situation has compelled healthcare organizations to operate with constrained resources while grappling with financial strain. Concurrently, healthcare leaders acknowledge the imperative of tackling widening health inequalities and environmental issues to ensure the sustainability and inclusivity of healthcare systems. The […]
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