Category: Blog

Outsourced Medical Billing Services

How Outsourced Medical Billing Services Improve Your Bottom Line

Outsourcing medical billing services can be an effective strategy to improve the financial health of your healthcare practice. By delegating the billing and coding tasks to a specialized third-party provider, you can streamline your revenue cycle, reduce administrative burdens, and enhance your profitability. However, medical billing can be a complex and time-consuming task that requires […]
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Bill Minor Procedure

How to Bill an E/M With a Minor Procedure

To determine the appropriate use of modifier 25, review this case study in otolaryngology. The Cigna Group has delayed the requirement for submitting documentation with claims that involve a 25 modified offices or other outpatient evaluation and management (E/M) service (CPT® 99212-99215) and a minor procedure. Despite the payer not enforcing this requirement, physician practices […]
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EHR Interoperability

The Future Impact of EHR Interoperability on Health Care IT: A Look into 2023 and Beyond

After years of longing for an update, the U.S. healthcare system is finally undergoing the crucial modernization it desperately needs. Dedicated IT professionals within healthcare organizations are now diligently developing enhanced electronic health records (EHRs) that promise increased efficiency and effectiveness. This transformative process entails integrating EHRs with state-of-the-art patient-access technologies. Consequently, various healthcare practitioners, […]
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SDoH Coding

Revisiting New Adjustments to SDoH Coding

In the 2024 ICD-10-CM, there are noteworthy changes to the SDoH codes Z55-Z65 that are worth mentioning. Instead of discussing minor formatting and grammatical adjustments made by CMS, I will concentrate on the significant changes. Here are the updates. ● Under the category of problems related to social environment (Z60.8), the ICD-10-CM now includes more […]
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Prior Authorization in Medicare Advantage

Prior Authorization in Medicare Advantage : Lawmakers Call for Streamlined Process

CMS has proposed a rule to simplify prior authorization in government-sponsored health insurance programs. However, some lawmakers are urging the agency to do more. A bipartisan coalition of 233 representatives and 61 senators have written a letter to CMS requesting that the proposed rules be expanded and that the changes be finalized quickly to enhance […]
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Telehealth Rule Changes

Congress Backs Permanent Telehealth Rule Changes

A new bill pending in Congress could make permanent the telehealth changes that proved beneficial to physicians and patients during the COVID-19 pandemic. Additionally, a leading physician group is now backing site-neutral payment for medical services. These two topics have recently been the subject of renewed discussion due to proposals by federal policy makers. CONNECT […]
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Adapting Risk Adjustment Coding

How Adapting Risk Adjustment Coding Can Change Healthcare Landscape?

Risk adjustment coding plays a vital role in the healthcare sector by capturing and documenting the severity of patient conditions. Its primary purpose is to guarantee precise reimbursement and risk adjustment scores. Given the ever-changing healthcare landscape, it is imperative for healthcare providers and coding professionals to remain adaptable and well-informed about the evolving requirements. […]
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Top Trends That Impacts Medical Billing Space in 2023

Challenges in the Medical Billing Space Medical coding and medical billing are two distinct yet interrelated tasks in the healthcare industry. Coding is the process of assigning standardized codes to diagnoses and procedures, while billing is the process of submitting claims to insurance companies for reimbursement. One of the biggest challenges in the medical billing […]
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