Category: Medical Billing

Healthier Horizons: Patient Experience Trends for 2024

Healthier Horizons: Patient Experience Trends for 2024

The healthcare landscape is undergoing an unprecedented evolution, set to drive a significant transformation in patient experience in 2024. Recent technological advancements, coupled with increased patient expectations for enhanced care, are converging with a comprehensive approach encompassing clinical, social, and behavioral facets of patient well-being. This convergence necessitates the modernization of care delivery systems to […]
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Evolution of Recovery Audit Contractor (RAC) Audits: Challenges, Changes, and Current Landscape

Evolution of Recovery Audit Contractor (RAC) Audits: Challenges, Changes, and Current Landscape

The inception of Recovery Audit Contractor (RAC) audits dates back to 2005, reaching their zenith around 2010 before encountering a deceleration amidst the COVID-19 period. In 2006, Congress granted the Centers for Medicare & Medicaid Services (CMS) the authority to launch the Recovery Audit Contractor program across three initial states: New York, Florida, and California. […]
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8 Successful Tactics for Reducing Denied Claims 2024

8 Successful Tactics for Reducing Denied Claims 2024

Roughly 65% of rejected claims aren’t reprocessed for resubmission (Zindl, 2021). As one of the healthcare industry’s numerous challenges, the upward trend of denied claims persists, with many left unaddressed. This has repercussions for both providers and patients alike. When denied claims remain unsubmitted, providers face substantial losses. Beyond revenue, these rejections strain staffing resources. […]
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Transparent e-Visit Billing: Essential Tips for Primary Care Physicians

Transparent e-Visit Billing: Essential Tips for Primary Care Physicians

In an era where digital progress is transforming every facet of the economy, healthcare is no different. Breakthroughs, particularly in telehealth and e-visits, offer the potential to make healthcare more accessible than ever. While these advancements bring significant promise, they also bring about fresh challenges, particularly in the realm of billing. A growing number of […]
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Key Survey Findings: Common Causes of Healthcare Claim Denials

Key Survey Findings: Common Causes of Healthcare Claim Denials

According to a recent survey, eligibility and prior authorization issues were among the most prevalent causes of claim denials. Hospitals and healthcare systems are experiencing an uptick in claim rejections due to errors in front-end revenue cycle processes. The Healthcare Financial Management Association’s Pulse Survey program, conducted for a healthcare technology company, gathered responses from […]
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Medicare Advantage Plans: What You Need to Know

Medicare Advantage Plans: What You Need to Know

Uncertain about the details of Medicare Advantage? Here’s what you need to know. The Medicare open enrollment period, running from Oct. 15 to Dec. 7 annually, is now underway. This gives you the chance to make adjustments to your current Medicare coverage. One potential change worth considering is transitioning from original Medicare (Parts A and […]
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Biden Administration Takes Action to Cut Medical Bills from Credit Reports

Biden Administration Takes Action to Cut Medical Bills from Credit Reports

On Thursday, the Biden administration revealed its intention to eliminate medical debt entries from Americans’ credit reports, aiming to put an end to what it views as coercive debt collection strategies affecting a wide swath of consumers. The proposed measures are designed to extend a financial lifeline to families grappling with medical crises, curbing the […]
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Telehealth vs In-Person Visits_ How Often Virtual Service Billed at Lower Code

Telehealth vs In-Person Visits: How Often Virtual Service Billed at Lower Code

According to research, telehealth visits, both in primary and specialty care, tend to be coded more frequently with lower level-of-service billing codes. Despite the option to receive higher facility rates for telehealth services for another year, providers often bill these virtual visits using lower level-of-service codes. This pattern holds true for both primary and specialty […]
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