Category: Medical Billing

7 Most Common Reasons for Claim Denials in 2023

7 Most Common Reasons for Claim Denials in 2023

When a claim gets denied, it not only affects the company’s cash flow but also impacts the patient-doctor relationship. Even some denials get claimed by re-appealing but few claims are left on air – that what something your practice and patient would like to avoid. Poor management in claim processing will negatively impact the revenue […]
Key Trends in Medical Billing Services for 2023

Key Trends in Medical Billing Services for 2023

Due to technological innovation, the healthcare sector faces greater transformation. Adopting new technologies and implementing virtual care brought significant change in Medical Billing. The year 2022 ends with a substantial rise in the adoption of payment systems and the implementation of new technologies in the Medical billing process. In addition, the integration of advanced Medical […]
Four Key Payment Trends That Impact Pediatric Practices

Four Key Payment Trends That Impact Pediatric Practices

For a modern medical practice, efficiency is everything. Labor costs continue to increase, putting a pinch on practices that are still recovering from pandemic shutdowns. An August 2022 snapshot of practices shows that, although physician productivity is increasing, expenses are growing faster than reimbursements. Every person in the practice must work at peak efficiency, from […]
A Medical Center Bills Patients’ Insurers For Messages

A Medical Center Bills Patients’ Insurers For Messages

  One of the nation’s largest hospital systems has begun charging for some electronic messages its doctors send to patients. On November 17 the hospital system began billing patients’ insurers for messages that typically take more than five minutes to answer and require a doctor’s “medical expertise,” according to an announcement on their website. Among […]
Highly Anticipated 2023 Medicare Final Rules Published

Highly Anticipated 2023 Medicare Final Rules Published

The final rules become effective Jan. 1, 2023. Amid this election season, the Centers for Medicare & Medicaid Services (CMS) has published final rules for the 2023 Part B Physician Fee Schedule and Medicare Shared Savings Program, the Outpatient Prospective Payment (OPPS) and Ambulatory Surgical Center (ASC) Payment System, the End-Stage Renal Disease (ESRD) Prospective […]
2023 MPFS and Quality Payment Program Final Rule Released

2023 MPFS and Quality Payment Program Final Rule Released

The conversion factor is down but certain public health emergency flexibilities will continue. The 2023 Medicare Physician Fee Schedule (MPFS) and Quality Payment Program final rule, released Nov. 1, allows Part B physician payment for behavioral healthcare, cancer screening, and dental care. But while the Centers for Medicare & Medicaid Services (CMS) continues its focus […]
Reasons for Holdups in the Medical Billing Process

Reasons for Holdups in the Medical Billing Process

The revenue cycle process within healthcare is intricate and has led to disconnections among various stakeholders, including physicians, coding teams, billers, and administrators. This has resulted in the diversion of time and staff resources away from patient care towards revenue collection efforts. This situation leads to lost revenue, diluted patient care quality, and decreased staff […]
Is Medicare Advantage Really a Disadvantage?

Is Medicare Advantage Really a Disadvantage?

It’s autumn, and along with leaves changing color, pumpkin spice lattes, and cooler weather comes an avalanche of TV ads, commercials, and telephone marketing calls, all entreating us to believe that Medicare Advantage (MA) is the best thing since the invention of the cell phone. With open enrolment season upon us, it’s critical to examine […]