The U.S. healthcare industry, marked by its global leadership in spending, faces mounting pressures due to evolving care models, supply chain disruptions, regulations, labor shortages, and rising costs. To navigate these challenges, healthcare leaders are prioritizing quality care delivery while also optimizing administrative operations, including revenue cycle management (RCM). Outsourcing RCM has become a key […]
Accounts receivable (AR) services are often overlooked but play a crucial role in the financial health of any business. These services involve managing the process of collecting outstanding payments from customers for goods or services sold on credit. Effective AR management can significantly impact a company’s cash flow, profitability, and overall financial stability. The Importance […]
Most Americans prefer the convenience of direct deposit for their paychecks. However, imagine if your employer deducted a 2-5% fee from each paycheck to cover the cost of electronic payments. While it seems absurd, this is the reality for many doctors in the U.S. Healthcare insurers and their payment processors often impose hidden EFT fees […]
Providers and coders should work together to maximize reimbursement by ensuring accurate coding, which is validated by thorough medical documentation. By focusing on ways to improve medical documentation for better reimbursement, providers can enhance patient care and ensure accurate reimbursement. Here are five ways to improve documentation, patient care, and reimbursement: 1. Avoid EHR Shortcuts […]
The success of a healthcare provider’s financial performance hinges heavily on the efficiency of its front-end revenue cycle management. While the mid and back-end processes, such as coding, billing, and denials management, often receive significant attention, it’s crucial to recognize the profound impact of pre-encounter activities on overall revenue cycle efficiency. Front-end revenue cycle encompasses […]
A new survey reveals a significant rise in cyberattacks on healthcare organizations since 2023. These attacks have led to substantial disruptions in patient care, with the average attack costing organizations nearly $1.5 million. According to the survey, 92% of healthcare IT and security professionals reported at least one cyberattack in the past year, up from […]
Medical claims processing has traditionally been a labor-intensive and error-prone task, involving manual data entry, verification, and adjudication. However, the advent of Business Process Automation (BPA) has revolutionized this process, making it more efficient, accurate, and cost-effective. Beyond the Basics: Advanced BPA Features While the core functionality of BPA in medical claims processing involves automating […]
The CPT license to use CPT codes is required for accessing the CPT code set, which is developed and maintained by the AMA as the standard medical language for reporting procedures and services in the US. This system is used by both public and private health insurance programs. CPT codes are also used for administrative […]
The U.S. Department of Health and Human Services (HHS) recently announced a $250,000 settlement with a Washington-based healthcare provider for alleged HIPAA violations. The violation stemmed from a ransomware attack and subsequent investigation by the HHS Office for Civil Rights (OCR) Ransomware Attacks and HIPAA Compliance: Protecting Patient Data: This settlement highlights a growing concern […]
The International Classification of Diseases, 10th Revision (ICD-10), is a standardized medical classification system developed by the World Health Organization (WHO). It categorizes diseases, injuries, and other health conditions, including ICD-10 Codes for Natural Disasters. For natural disasters, the ICD-10 provides specific codes to classify related injuries and health issues. Here are some of the […]