Category: Medical Billing

AI Reduces Surprise Bills

Enhancing Payment Integrity With AI To Eliminate Surprise Bills

It’s common for people to feel surprised by the cost of hospital, medical imaging, or outpatient surgery bills. Unfortunately, it’s difficult for them to verify whether the bill is accurate or not. This is because incorrect medical bills have become increasingly common. To address this issue, organizations are turning to technologies such as artificial intelligence […]
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Medicare Advantage Insurers

Senators seek accountability from Medicare Advantage insurers on claims denials

In Congress this week, it wasn’t just pharmacy benefit managers facing scrutiny. The Senate’s Permanent Subcommittee on Investigations directed its attention towards Medicare Advantage (MA) plans, seeking explanations for claims denials. During the hearing, the committee’s chairman highlighted that letters were sent to the three largest MA plans—UnitedHealthcare, Humana, and Aetna—requesting documentation regarding their decision-making […]
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Revive Medicare for All Bill

Progressive Lawmakers Revive Medicare for All Bill

Other progressive legislators from the House and Senate have brought back a Medicare for All bill. The proposed legislation aims to transition towards a single-payer health system by leveraging the existing federal program. Representatives, along with a coalition of 14 senators and 110 House members. The lawmakers are motivated by the devastating impact of the […]
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New Healthcare AI Tools

New AI Tools for Efficient Billing and Enhanced Testing

The integration of artificial intelligence into health IT vendor offerings for provider operations, medical testing, patient engagement, and various other use cases has led to a remarkable pace of innovation in the industry. AI-Powered Billing Assistants Seattle-based Healthtech company, established in 2021, made an announcement on Tuesday regarding the expansion of its cloud-powered AI Application […]
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cigna-updates-modifier-25-reimbursement-policy

Cigna Updates Modifier 25 Reimbursement Policy

Find out what you must do to get significant, separately identifiable E/M services paid. The Cigna Group recently updated its reimbursement policy for modifier 25. Effective May 25, if you are billing this health insurance company for an evaluation and management (E/M) service and a minor procedure, you may need to do more than append […]
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5 Qualities of a Great Physician Billing Solution

Discover the Top 5 Qualities of a Great Physician Billing Solution

Ensure you make a well-informed choice when selecting a company to manage your reimbursements. Physicians seeking to improve their reimbursement rates, financial performance, operational efficiency, or focus on patient care should consider outsourcing their billing needs. However, choosing the right physician billing service for your practice can be a challenging task, as not all services […]
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Tips to Optimize Cardiology Billing and Coding Process

Top Tips to Optimize Your Cardiology Billing and Coding Process

Cardiology Medical Billing and Coding Process: To effectively handle these changes, cardiology practitioners might have to keep themselves informed about the modifications in payment regulations, modify their billing procedures as needed, and employ novel methods to enhance their compensation. Cardiology billing and coding can be challenging due to various factors, such as the complexity of […]
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Updates to UnitedHealthcare's Reimbursement Policies

UnitedHealthcare Implements 9 Changes to Reimbursement Policies for May

On May 1, UnitedHealthcare made nine changes to its reimbursement policies for its commercial, individual and family, and Medicare Advantage plans. Some of the changes go into effect June 1, while others will begin August 1. Here are nine UnitedHealthcare reimbursement changes happening in the coming months: Commercial plans: Molecular pathology policy, professional and facility: […]
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10 Tips to Clean Medicare Part-B Claims

10 tips to Squeaky Clean Your Medicare Part-B Claims

Don’t allow preventable error to disrupt your revenue cycle. In order for a claim to be considered clean, it must contain all necessary information for the payer to fully process it without requiring further investigation or development. This includes being submitted within the designated timeframe, passing all necessary reviews, having any required medical evidence or […]
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Revenue Cycle Billing Challenges

Revenue Cycle Billing Challenges: Insights from Patient Experience

To enhance the financial experience of patients, it is crucial to closely examine an organization’s billing procedure. HealthLeaders is joining the celebration of Patient Experience Week from April 23-29 by highlighting the efforts of revenue cycle leaders in establishing a favorable financial experience for patients in their organizations. With a suboptimal financial experience capable of […]
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