In medical coding, CPT modifier are vital for accurate reimbursement of healthcare services. These special codes, attached to primary procedure codes, provide additional details about the complexity or extent of a service. However, using modifiers incorrectly can lead to claim denials and lost revenue. This blog post shares six key tips to help you get […]
The Prime Minister’s recent voluntary national survey shed light on the Denied claims. The survey, conducted between October and December 2023, found that nearly 15% of all Medicare Advantage, Medicaid, Commercial and Managed Medicaid claims were denied. Between 45% and 60% of rejected cases were overturned, although the expensive appeals process sometimes meant multiple appeals. […]
It is imperative that medical billing be as efficient as possible in today’s fast-paced healthcare environment in order to achieve financial stability and maintain a thriving practice. We must admit, however, that monotonous tasks and constant change can quickly lead to burnout. The purpose of this newsletter is to provide you with five key strategies […]
Claims Denial: Healthcare Leaders report an increase in payer denials, putting increasing pressure on the system’s finances. Going back and forth with denied payers is a long and expensive process, and low reimbursement rates don’t help either. In a new survey conducted by the Healthcare Financial Management Association, CFOs noted a significant increase in denials, […]
The Medicare Advantage and Part D rule was implemented on January 1 by CMS. Despite the fact that the Medicare Advantage and Part D rule which came into effect on January 1, 2019 is now in effect, it is quite early to tell whether 2024 will be the year when providers finally overcome the challenges […]
ICD-10 audits. Just the mention sends shivers down the spines of healthcare providers everywhere. These meticulous examinations hold the power to either boost your bottom line or leave you facing a financial black hole. But fear not! By embracing precision coding, you can transform audits from dreaded foes into powerful allies that protect your reimbursements […]
Denial rates, notably within Medicare Advantage, are on the rise, impacting both hospital revenue cycles and patient care, remarked the executive director of a Minnesota-based large multispecialty health care organization focused on Revenue Cycle management. Despite the organization reporting a favorable margin this year, it falls short in achieving profits comparable to those of insurers, […]
Denial management in rcm: In the intricate realm of healthcare revenue cycle management (RCM), the substantial challenge revolves around handling denied claims. Scarcity of resources, understaffing, and restricted capacity frequently lead to difficulties in resolving denied claims, where an alarming 82% to 90% are considered potentially preventable. RCM teams can optimize time and revenue recovery […]
According to a survey, claim denials are considered the biggest obstacle in revenue cycle management, with over 20% of providers reporting an annual loss of $500K due to these denials. A recent survey of healthcare leaders conducted by leading medical billing company revealed that claim denials are causing a significant and costly issue for healthcare […]
Prompt payment to healthcare providers for their services is crucial for a detailed discussion on managing macro costs, quality, and equity. Without it, addressing the issue of rising healthcare costs becomes challenging. Healthcare providers are well aware that getting paid is not an easy task. A quick search for revenue cycle management (RCM) reveals 16-step […]