Category: Medical Billing

Enhancing Claims Management

Enhancing Claims Management: Identifying Errors, Maximizing Efficiency, and Streamlining Operations

Claims management serves as a valuable tool for insurance firms, enabling them to identify the root causes of claim errors, measure areas for improvement, and explore new opportunities to continuously enhance their operations. However, the ever-increasing complexity of claims administration poses a formidable challenge for insurance businesses, hindering their ability to uncover fresh prospects and […]
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Tips to Avoid Billing Errors in Radiology Practices

Have you ever received a medical bill that left you perplexed, questioning how the expenses added up and left you scratching your head? If that’s the case, you’re certainly not alone. Billing for radiology can be intricate and confusing, involving numerous codes and procedures. Unfortunately, errors in medical billing are all too frequent, resulting in […]
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Top 6 Medical Billing Changes

The Top 6 Changes in Medical Billing

Table of Contents The Top 6 Changes in Medical Billing Implementation of ICD-11 Increased Use of Telehealth Services Changes in Reimbursement Rates Increased Focus on Patient-Centered Care Greater Emphasis on Data Security Focus on Price Transparency The healthcare industry is constantly evolving, and medical billing is no exception. With the ever-changing landscape of healthcare, it’s […]
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Advantages of Claim Scrubbing

Unveiling the Advantages of Claim Scrubbing

Claim scrubbing enables the potential for increased accuracy in claims, enhanced client relationships, and improved patient interactions. Claim scrubbing is the process of identifying and rectifying coding errors in medical claims prior to their submission to insurance providers. Whether conducted manually or through automated systems, claim scrubbers validate medical claims before they are sent to […]
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Automating Claim Processing

Automating Claims Processing in the Healthcare Industry

By utilizing automation, it is feasible to improve the upstream and downstream adjudication process through data validation and routing. The healthcare industry can benefit from automation in almost all administrative functions, but it can significantly improve the auto-adjudication rate. In an ever-changing industry, possessing technical expertise is of utmost importance. The healthcare sector is increasingly […]
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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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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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