Tag: Claim Denials

Modifier 25 healthcare billing

Modifier 25: Essential Tips for Accurate Billing and Compliance

Description: Modifier 25: Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service. Navigating the Challenges of Modifier 25 in Healthcare Billing Modifier 25 healthcare billing in continues to be a source of frustration for healthcare providers. Health […]
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CPT Modifier

Six Tips to Getting Paid for CPT Modifiers

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 […]
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healthcare denied claims impact and appeals

Unlocking the Secrets of Denied Claims: Insights, Solutions, and Strategies

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. […]
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5 Ways to Supercharge Your Medical Billing Efficiency

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 […]
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5 Ways to Reduce Claims Denial in Your Revenue Cycle

Reduce Claims Denial in Your Revenue Cycle

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, […]
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Impacts of Claim Denials on Revenue Cycle

How Claim Denials and Payer Audits Impacts Healthcare Revenue Cycle

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, […]
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Denial Management in RCM

Navigating Denial Management Challenges in Revenue Cycle Management

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 […]
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The True Cost of Claim Denials in Healthcare

The True Cost of Claim Denials in Healthcare

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 […]
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