Category: Blog

Higher-Bills-Lead-To-Delay-Medical-Care

Higher Bills Are Leading Americans To Delay Medical Care

Inflation and pressing household expenses are forcing some people to postpone health needs, an emerging trend that has health experts worried that conditions may only worsen. Megan Swanson has warily watched the erosion of her family’s savings as inflation chips away at a reserve for emergencies. She often postpones any regular doctor’s appointments, including her […]
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Practical-Tips-For-Reducing-Claims-Denials

Practical Tips For Reducing Claims Denials

Medical claims denials are on the rise and continue to be a costly problem for health systems. Unfortunately, the vast majority of providers focus their resources on reactive responses, working to appeal denials and recover payments after denials have already occurred. In a Becker’s Healthcare podcast an expert, discussed the problem of rising denials, why […]
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Need-for-Eligibility-Checks-for-Visits

Understanding the Need for Eligibility Checks for Visits

While these activities oftentimes become challenging, they should help in facilitating reimbursement. This month, we’ll dive into the next steps needed for medical practices to take after being credentialed to maximize the chances of receiving reimbursement. The next critical steps after getting credentialed are (1) to conduct eligibility checks for patient visits and (2) get […]
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Coding-of-Cardiac-Conditions-Takes-The-Center-Stage

Coding of Cardiac Conditions Takes The Center Stage

February may be American Heart Month, but correctly diagnosing and coding cardiac conditions requires healthcare professionals to work hard to get right 365 days a year. Outlining coding guidance for pulmonary hypertension – a rare condition that nonetheless can be particularly deadly, often because it is not diagnosed until it is in advanced stages. It […]
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Hospitals-Comply-with-the-Price-Transparency-Rule

Only a Few Hospitals Comply with the Price Transparency Rule

Over 1,500 hospitals reviewed in the report were noncompliant with at least one requirement of the price transparency rule between December 2022 and January 2023. Less than a quarter of hospitals are complying with the hospital price transparency rule over two years after the regulation went into effect, according to a report from PatientRightsAdvocate.org. The […]
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Important-Changes-to-ICD-10-CM-Codes-and-Guidelines

Important Changes to ICD-10-CM Codes and Guidelines

New codes and updates become effective April 1. The updates to ICD-10-CM and ICD-10-PCS that become effective April 1 were released in mid-January. The updates include 42 new diagnosis codes. The significant changes to the ICD-10-CM guidelines are the following: A.19 – Code Assignment and Clinical Criteria This section has added a new sentence: “If […]
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