Category: Medical Billing

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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Health care bill with a wide range of provisions would impact physicians

Health care bill with a wide range of provisions would impact physicians

The Senate Finance Committee proposed that the full chamber should review a legislation that could instigate alterations in physician practices. This proposition was discussed during a 90-minute meeting on November 8, 2023, regarding the bill named “The Better Mental Health Care, Lower-Cost Drugs, and Extenders Act.” This bill encompasses diverse aspects of healthcare, including mental […]
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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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Financial planning for Surprise Medical Bills

Financial planning for Surprise Medical Bills

Costly medical emergencies have the potential to impose a significant financial strain. It’s important to recognize that unexpected and expensive health issues can affect anyone. While we can’t predict when or if we’ll face an unforeseen health challenge, we can take steps to be financially ready. Below are some approaches to kick start your preparations. […]
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5 Tips for Right Medical billing outsourcing provider

5 Tips for Right Medical billing outsourcing provider

Medical billing outsourcing provider: The healthcare industry is constantly evolving, and medical billing is no exception. The ever-changing regulatory landscape, complex insurance plans, and increasing patient volumes can make it difficult for healthcare providers to keep up with their billing and coding needs. This is where outsourcing medical billing services can come in handy. Outsourcing […]
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